The American Health Lawyers association reported the following in its weekly Fraud and Abuse update:
The government won or negotiated more than $2.5 billion in healthcare fraud judgments and settlements in fiscal year (FY) 2016, the Departments of Health and Human Services (HHS) and Justice (DOJ) said in their Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2016 released January 19.
“In its twentieth year of operation, the Program’s continued success confirms the soundness of a collaborative approach to identify and prosecute the most egregious instances of health care fraud, to prevent future fraud and abuse, and to protect program beneficiaries,” the agencies said.
According to the report, as a result of 2016 and prior years’ efforts, over $3.3 billion was returned to the federal government or paid to private persons. The Medicare Trust Funds received transfers of approximately $1.7 billion, and $235.2 million in federal Medicaid funds was transferred to the Treasury in FY 2016, the report said.
OIG investigations also led to 690 civil actions, which include false claims and unjust-enrichment lawsuits filed in federal district court, civil monetary penalties settlements, and administrative recoveries related to provider self-disclosure matters, according to the report. OIG also excluded 3,635 individuals and entities in FY 2016.