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Feds announce new efforts to curb health care fraud

By Phillips & Cohen LLP

The Justice Department and the Dept. of Health and Human Services announced the creation of a new interagency effort to combat Medicare fraud.

In addition to the new Health Care Fraud Prevention and Enforcement Action Team (HEAT), the two agencies will add joint DOJ-HHS Medicare Fraud Strike Forces in Detroit and Houston. There are already such strike forces in South Florida and Los Angeles.

The strike forces use a data-driven approach to identify unexplainable billing patterns and investigate those providers for possible fraudulent activity. The Florida team has already convicted 146 defendants and secured $186 million in criminal fines and civil recoveries. In Los Angeles more than $55 million has been ordered in restitution to the Medicare program.

Full post as published by False Claims Act - Qui Tam on May 20, 2009 (boomark / email).