Medicare Compliance & Reimbursement

DOJ boast sheet touts record-setting fraud haul.  Think health care fraud enforcement is easing up after years of aggressive scrutiny? Think again. The feds collected a record-setting $1.6 billion from providers, suppliers and others they suspected of ripping off the Medicare and Medicaid program in fiscal year 2002. "This is the largest return to the government" since enforcement was dramatically stepped up in 1996, the Department of Justice and the Department of Health and Human Services brag in their 2002 Annual Report for the Health Care Fraud and Abuse Control Program. Released Oct. 6, the report tallies the results of enforcement activities undertaken by the DOJ and the HHS Office of Inspector General. The results for 2002: prosecutors filed 361 criminal indictments for health care fraud; 480 defendants were convicted for health care fraud-related crimes; 1,529 civil cases were pending, 221 of them newly filed; and HHS excluded a whopping 3,448 providers and suppliers from Medicare and Medicaid. The exclusions involved Medicare and Medicaid fraud, patient abuse or neglect and license revocations. To see the report, go to www.usdoj.gov/dag/pubdoc/hcfacreport2002.htm. Lesson Learned: Health care providers who run afoul of Medicare and Medicaid rules remain squarely in the cross hairs of government enforcement agencies.