The latest report released by the Health Care Fraud and Abuse Control Program (HCFAC) reflects an unprecedented $4.1 billion dollars that was recovered from organizations and individuals who attempted to defraud the U.S. government by receiving improper health care reimbursements. The record amount represents the largest sum ever recovered in one year, and the recovery of the funds saves taxpayer dollars by returning money to the Medicare Trust Fund, the Treasury and other related programs.

The HCFAC report is released annually and is a joint effort of the Department of Health and Human Services (HHS) and the Justice Department. The report reflects the unqualified success of the Obama Administration's decision to make the elimination of fraud and waste a top priority. One of the major factors in this effort was the creation of the Health Care Fraud Prevention and Enforcement Action Team (HEAT) in 2009 to zero in on fraudsters abusing the Medicare and Medicaid programs.

Another change implemented in 2009 was the addition of more Medicare Fraud Strike Force Teams. Each team features personnel from the FBI, the Justice Department, and the HHS Office of Inspector General working together using advanced data analysis to identify unusual billing patterns which often indicate fraud. In 2011 alone, the Medicare Strike Force teams removed almost 200 Medicare fraud defendants from the health care system, with the majority facing an average prison sentence of almost 4 years. Including the strike force defendants, a record 743 federally prosecuted defendants were found guilty of health fraud.

An infusion of an additional $350 Million dollars to support the continued efforts of the HCFAC program combined with the implementation of additional fraud fighting provisions in the Affordable Care Act like improved cross agency data sharing, monitoring of private insurance abuse, and stronger screening standards will provide even more tools to combat fraud in health care reimbursements. The Affordable Care Act also opened the door for the establishment of definitive deadlines for the return of taxpayer money once an organization becomes aware that they have received Medicare or Medicaid overpayments, greatly improving the ability of the government to recover overpayments in a timely manner.

The Obama Administration also initiated an increased effort to educate Medicare recipients on ways to protect themselves from fraud, and educate Medicare providers via compliance training and regional summits on the best practices for avoiding fraud and complying with federal and state law.

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Tausif Rahman, a Detroit-area resident, has pleaded guilty to participating in a money laundering scheme as well as Medicare Fraud. The fraud and money laundering scheme is estimated to have cost the tax-payers $14 million. 

According to a recent DOJ press release, Marietha Morales and Eduardo Saborit-Dominguez; the owner and employee of a Miami healthcare agency,  have pleaded guilty to charges involving a $22 million home health Medicare fraud scheme.