Feb. 11—The U.S. government recovered $4.2 billion in health care-related fraud and abuse investigations in FY12, up from almost $4.1 billion in FY11, according to the Health Care Fraud and Abuse Control (HCFAC) Program’s annual report. 

The amount is the highest three-year average ROI in the 16-year history of the HCFAC Program, a joint effort of the U.S. Department of Justice and the U.S. Department of Health and Human Services to coordinate federal, state, and local law enforcement activities to fight healthcare fraud and abuse.

As part of the combined effort, Medicare Fraud Strike Force teams use advanced data analysis to identify high billing levels in healthcare fraud “hot spots” so that interagency teams can target emerging or migrating healthcare fraud and abuse schemes. The analyses also help to identify chronic fraud by criminals masquerading as healthcare providers or suppliers. 

Publication Date: Monday, February 11, 2013