Federal Officials Say Crackdown On Medicare Fraud Recovers $2.5 Billion

The Associated Press: "The government says it recovered $2.5 billion in overpayments for the Medicare trust fund last year as the Obama administration focused attention on fraud enforcement efforts in the health care industry. Investigators have new tools this year to help crack down on health care fraud, with the Justice Department and the Health and Human Services Department working cooperatively to police companies. The newly enacted Affordable Care Act is designed to lengthen prison sentences in criminal cases and the new law provides an additional $300 million over the next 10 years for stronger enforcement. It also gives the government new authority to step up oversight of companies participating in Medicare and Medicaid. ... In a report being released Thursday, the Justice Department and HHS say they are putting investigative resources in areas where health care fraud is especially widespread, including south Florida; Los Angeles; Houston; Detroit; New York City's Brooklyn borough; Baton Rouge, La.; and Tampa, Fla. ... At the same time, federal investigators are blocking unscrupulous companies from getting into government health care programs in the first place" (5/13).

In other health care fraud news:

NJ Today: "New Jersey has received $1.3 million in a settlement with Aventis Pharmaceuticals Inc. regarding 'best price' violations and resulting losses to New Jersey's Pharmaceutical Assistance to the Aged and Disabled (PAAD) and Senior Gold (SG) Pharmaceutical Assistance programs, Attorney General Paula T. Dow and Criminal Justice Director Stephen J. Taylor announced yesterday. According to Acting Insurance Fraud Prosecutor Riza Dagli, the $1.3 million recovery for New Jersey stems from the same allegations that led to a separate settlement late last year involving the Medicaid program, in which New Jersey received $1,043,141 from Aventis" (5/12).

Rocky Mount Telegram: "A local home health care agency is under investigation by state authorities for possible fraud after a letter was sent to its clients urging them to appear as if they are in dire need of medical attention. Medicaid fraud investigators from the N.C. Attorney General's office are looking into the operations of Oasis Home Care Services after discovery of a draft letter stating that clients should let state nurses know they 'really need' in-home [assistance] specifically from that agency. The personal care service provider opened in 2006 and helps elderly or disabled people with home care such as bathing, dressing, food preparation and cleaning. Oasis Home Care Services Director Doris Williams recently sent a letter to clients notifying them that starting May 1, state registered nurses would be conducting assessments, reassessments or supervisory visits to determine whether clients still are eligible for in-home aid" (Cooper, 5/12).

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