Feds Progress Against Medicare Fraud Stalling

January 29, 2010

A Justice Department released a report earlier this week explaining that the number of people being arrested and charged for Medicare fraud has barely increased over the past two years. Despite the federal government's promise to fight healthcare fraud, little progress is being made according to the report. That fact is hard to believe because at least once a week local papers write articles describing the latest Miami Medicare fraud cases. The report indicated that federal prosecutors indicted 803 individuals with Medicare fraud this year. Federal authorities are disturbed that the prosecution rate has only increased 2% since 2007, the year the Medicare strike forces began to take shape. The numbers may be skewed because the report does not include the number investigations that are pending this year, as compared with 2007.

Again, politics is entering the picture in the battle against health care fraud. Democrats are trying to curb the fraud and use the benefits to assist in paying for the government run healthcare plan. The politicians want to save the tax payers from the $60 billion a year fraud and use the money to support the new plan. Obama's administration gathered experts in Washington, D.C. to get ideas prevent the extensive losses. Current safeguards are mostly limited to recovering losses as a result of fraud, and not preventing the fraud before it happens. Only the largest of Medicare fraud cases are often prosecuted in federal court. A federal prosecutor was quoted as saying, "While we can't prosecute our way out of health care fraud problem, we are making sure that we're using innovative ideas like the Medicare fraud strike forces to detect and prosecute healthcare fraud."

Based on the large number of arrests and prosecutions in Miami, the strike forces appear to have been working, at least in South Florida. The Justice Department set up a team of an investigators and prosecutors to combat the ongoing the ongoing problem. Based on the apparent success in Miami, the federal government set up strike forces in six other cities including Baton Rouge, New York and Tampa. Opponents of the strike forces are using the report in several ways. Opponents of Obama's plan routinely say that if the current administration cannot clean up the health care fraud, how can they possibly think they can create a health care system that will work?

Initially, the number of prosecutions in fraud cases jumped %35, but the numbers have remained stagnant since that time. However, the statistics do not take into consideration if the number of pending investigations have increased significantly during the same time frame. With the focus on these types of fraud offenses, prosecutors will seek, and the judges will hand down severe sentences for those convicted of health care fraud. Anyone being investigated for or having been arrested for their involvement in a Medicare fraud case should seek assistance from a Miami criminal defense attorney defending these types of cases in federal court.

Little Progress Seen Against Health Insurance Fraud, USA Today, January 28, 2010.