Government Recoups $1.9 Billion in Health Care Fraud in FY15 More than 50 percent of the $3.5 billion recovered under the False Claims Acts in fiscal year 2015 came from companies and individuals in the health care industry that allegedly provided unnecessary or inadequate care, paid kickbacks to health care providers, or overcharged for goods and services paid for by ... News in Brief
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News in Brief  |   February 01, 2016
Government Recoups $1.9 Billion in Health Care Fraud in FY15
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Regulatory, Legislative & Advocacy / News in Brief
News in Brief   |   February 01, 2016
Government Recoups $1.9 Billion in Health Care Fraud in FY15
The ASHA Leader, February 2016, Vol. 21, 13. doi:10.1044/leader.NIB3.21022016.13
The ASHA Leader, February 2016, Vol. 21, 13. doi:10.1044/leader.NIB3.21022016.13
More than 50 percent of the $3.5 billion recovered under the False Claims Acts in fiscal year 2015 came from companies and individuals in the health care industry that allegedly provided unnecessary or inadequate care, paid kickbacks to health care providers, or overcharged for goods and services paid for by Medicare, Medicaid and other federal health care programs.
The $1.9 billion recovered by the U.S. Department of Justice in health care fraud reflects only federal losses. In many of the cases, the department helped to recover additional millions of dollars for consumers and state Medicaid programs.
The False Claims Act allows the government to file civil suits to recoup losses from false claims related to federal contracts and programs. Most actions are filed under whistleblower provisions that provide incentives for people to file lawsuits alleging false claims on behalf of the government.
Although most health care fraud involves kickbacks and improper financial relationships between hospitals and physicians, funds have also been recovered from skilled nursing homes and rehabilitation facilities.
Extendicare Health Services Inc. and its subsidiary Progressive Step Corporation paid $38 million in October 2014 to resolve allegations that included billing Medicare for medically unreasonable and unnecessary rehabilitation therapy services. The Justice Department maintains ongoing litigation against additional nursing home chains and rehab centers based on similar allegations.
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February 2016
Volume 21, Issue 2