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Fighting Health Care Fraud: The Power of One

Posted By Lisa McElroy On January 17, 2014 @ 1:29 pm In Legal Grounds | Comments Disabled

Nurse in handcuffs [1]Can a single federal prosecutor make much of a difference in the war against health care fraud [2]?

Yes, a new analysis [3] of Justice Department statistics suggests. And the stakes are enormous: Fraud is thought to cost the Medicare program alone up to $90 billion each year.

The analysis – from the Transactional Records Access Clearinghouse (TRAC), a nonprofit group based at Syracuse University – shows that federal prosecutors filed a record number of new health care fraud cases in fiscal 2013: 377, or more than one for every day of the year. The U.S. Attorney’s Office for the Southern District of Illinois, which covers 38 counties and a population of about 1.2 million, led the way, with a prosecution rate that was more than eight times the national average.

>> Sign up for the AARP Money newsletter [4]

The federal prosecutor there, U.S. Attorney Stephen Wigginton [5], told the Associated Press that he was “frankly surprised” to learn that his office was in the No. 1 spot. But perhaps he shouldn’t have been. Wigginton told AP [6] that, since his appointment in August 2010, he’s placed a special emphasis on fighting health care fraud. Last year, for example, his office indicted more than 30 individuals [7] for allegedly defrauding a Medicaid program that’s meant to keep people out of nursing homes by paying personal assistants to help them with general household activities and personal care.

“I think we’re very focused and strategic,” Wigginton says.

The lesson hasn’t been lost on Washington. Attorney General Eric Holder, as I wrote back in November [8], has created a Medicare Strike Force that’s working hard to fight fraud in nine cities nationwide.

“We’re pleased efforts to crack down on Medicare fraud have been returning results,” said Ariel Gonzalez, director of AARP’s federal health and family advocacy. “We continue to encourage individuals to take a detailed look at their explanation of benefits and report things of concern.”

Learn more about how to protect yourself at the Fight Health Care Fraud [9] page on the AARP website.

Photo: JaggedPixels/iStockPhoto [10]

>> Get travel discounts with your AARP Member Advantages. [11]

 

Also of Interest

 

See the AARP home page [16] for deals, savings tips, trivia and more

 


Article printed from AARP: http://blog.aarp.org

URL to article: http://blog.aarp.org/2014/01/17/fighting-health-care-fraud-the-power-of-one/

URLs in this post:

[1] Image: http://blog.aarp.org/wp-content/uploads/2014/01/iStock_000017751499Small.jpg

[2] health care fraud: http://blog.aarp.org/2013/11/15/is-your-hospital-in-medicares-penalty-box/?intcmp=AE-BLIL-BL

[3] new analysis: http://trac.syr.edu/tracreports/crim/338/

[4] >> Sign up for the AARP Money newsletter: http://www.aarp.org/online-community/people/subscribeFromEmail.action?id=29636&intcmp=ILC-EMAIL-SUB-MONY

[5] Stephen Wigginton: http://www.justice.gov/usao/ils/meetattorney.html

[6] told AP: http://bigstory.ap.org/article/report-health-care-fraud-cases-hit-high-last-year

[7] indicted more than 30 individuals: http://www.justice.gov/usao/ils/News/2013/July/07112013_Medicad%20Press%20Release.html

[8] as I wrote back in November: http://blog.aarp.org/2013/11/12/meet-the-medicare-fraud-fighters/?intcmp=AE-BLIL-BL

[9] Fight Health Care Fraud: http://www.aarp.org/health/medicare-insurance/fight_health_care_fraud.html?cmp=RDRCT-FIGH_NOVE24_010

[10] JaggedPixels/iStockPhoto: http://www.istockphoto.com/user_view.php?id=2850915

[11] >> Get travel discounts with your AARP Member Advantages.: http://discounts.aarp.org/travel/index/uSource/HCTN?intcmp=AE-BL-TRV-DISC

[12] Fraud Watch Network Fights ID Theft and Scams: http://blog.aarp.org/2013/11/12/fraud-watch-network-fight-id-theft-and-scams/ ?intcmp=AE-ENDART1-BL-REL

[13] Photos: Burt Reynolds and 8 Other Stars That Went Broke: http://www.aarp.org/money/credit-loans-debt/info-12-2012/celebrities-who-went-broke-slideshow.html#slide1?intcmp=AE-ENDART2-BL-BOS

[14] Get free assistance with tax-return preparation from Tax-Aide: http://www.aarp.org/money/taxes/aarp_taxaide/?intcmp=AE-ENDART3-BL-ADV

[15] Join AARP: https://appsec.aarp.org/MSS/join/application?keycode=U9ZTPH9&intcmp=AE-ENDART3-BL-MEM

[16] AARP home page: http://www.aarp.org/?intcmp=AE-ENDART3-BL-HP

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