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PRACTICE MANAGEMENT

Record Health Care Fraud Cases in 2013

Laura Joszt | Thursday, January 16, 2014
A record number of health care fraud cases were prosecuted in fiscal year 2013, according to data from the Justice Department.
 
Every year thousands of physicians are victims of medical identity theft for the purpose of Medicare fraud. (See how to prevent this theft.)
 
A nonprofit group based at Syracuse University obtained the statistics through a Freedom of Information Act to track federal enforcement activities. The information found that prosecutors pursued 377 new federal health care fraud cases in the fiscal year that ended in October.
 
The cases filed represent a new record, which possibly reflects that the government has placed more emphasis on combating the sort of crime that costs taxpayers money, according to the Associated Press.
 
The number of cases filed in 2013 represents a 3% increase over the previous year and a 7.7% increase from five years ago and a 10% increase from a decade ago, according to the Transactional Records Access Clearinghouse at Syracuse University.
 
In East St. Louis there were 10.1 prosecutions in this area per 1 million people — more than eight times the national average. There has been a huge growth in the rate of prosecutions in this judicial district. According to the data from TRAC, prosecutions were up 1,200% from a year ago.
 
Miami was a close second with 8.8 prosecutions per 1 million people. Third place South Carolina reported 7.2 prosecutions per million, which is a 709% increase from five years ago.
 
A huge push came toward the beginning of 2013 when 89 people in eight cities were charged for their alleged roles in Medicare scams billing the program for $223 million in fraudulent charges, according to the AP. Instead of paying first and investigating suspicious claims later, authorities are now flagging those claims before paying them.
 
Attorney General Eric Holder has estimated in the past that Medicare fraud costs the government and taxpayers $60 to $90 billion.



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