Did you hear that our country’s fraud prevention efforts in fiscal years 2013 and 2014 resulted in $42 billion saved? That is an average of $12.40 saved for every $1 spent on fraud prevention efforts! This is a huge success for both the health and safety of beneficiaries and our Medicare program. Preventing Medicare fraud doesn’t just save the government money, it also protects beneficiaries from having unnecessary tests, being prescribed drugs or treatment they don’t need and that could be harmful to their health, and it ensures the health and longevity of the Medicare program for future generations.
A major factor to make this success happen was the passage of the Affordable Care Act (commonly referred to as Obamacare) which greatly increased funds to protect Medicare’s integrity and prevent fraud. These funds were used to increase the Medicare Fraud Strike Force from 2 to 9 cities; make sure health care providers enrolled in Medicare and Medicaid programs are properly screened; create and use predictive analytics to prevent fraud, waste, and abuse; and coordinate anti-fraud efforts with federal and external partners, such as our Senior Medicare Patrol.
Also, as quoted in a recent NY Times article, “to date, 2,000 of 2,900 defendants charged with felony health care fraud in strike force cases have been convicted. Most have been sentenced to prison, not merely probation. In addition, courts have ordered defendants to repay the government more than $5.5 billion, which is about the total amount the government paid out in the frauds that have been prosecuted.”
All of this success comes from and shines through the commitment and teamwork of multiagency networks and partners across the country committed to quality health care, program integrity and the safety and wellbeing of our beneficiaries.