Medicare Fraud Crackdown Intensifies


CHICAGO, (UPI) —  Criminals face sentences 20 percent to 50 percent longer for Medicare fraud involving more than $1 million, under the Affordable Care Act, U.S. officials say.

At a Chicago summit highlighting new high-tech tools to be used against healthcare fraud, U.S. Health and Human Services Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder said the Health Care Fraud Prevention and Enforcement Action Team — known as HEAT — helped recover more than $4 billion in fiscal year 2011 — an all-time high.

“We have a simple message to criminals thinking about committing Medicare fraud: Don’t even try,” Sebelius said in a statement. “Thanks to health reform and our administration’s work, we have new tools and resources to catch criminals and stop Medicare fraud before it happens.”

More than 49,000 complaints of fraud from seniors and people with disabilities reported to 1-800-MEDICARE were referred for further evaluation.

Holder said as a result of the administration’s efforts to fight healthcare fraud, contractors that police Medicare for waste, fraud, and abuse will expand their work to cover Medicaid, Medicare Advantage and Medicare Part D programs.

HHS ended the billing privileges of 4,850 Medicaid providers and suppliers and deactivated 56,733 Medicare providers and suppliers in 2011, as it took steps to close vulnerabilities in Medicare, Sebelius said.

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