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Press Conference on Health Care Fraud and the Affordable Care Act

May 13, 2010

Washington, DC

Good afternoon. Thank you all for joining us.

I’m glad to be joined today by Attorney General Holder and members of our department’s senior leadership to provide an update on our efforts to stamp out waste and fraud in our health care system, protect consumers, and safeguard taxpayer dollars.

As the Affordable Care Act has kicked in over the last few weeks, Americans around the country have been getting some long overdue good news about health care.

Small businesses have been notified that they’ll be receiving tax credits to help them provide health care coverage for their employees.

Young adults have learned they’ll now be able to stay on their parents’ health insurance plans until they turn 26.

And seniors who have fallen into the prescription drug donut hole are looking forward to rebate checks next month that will help them afford their medications.

Slowly but surely, Americans are getting more control over their health care. A more consumer-friendly market for health insurance is starting to take shape.

Unfortunately, just as the future of our health care system is looking brighter, we’re hearing reports of criminals trying to exploit these changes. In states like Delaware and Wyoming, we’ve heard that scam artists are calling up seniors and telling them they need to share their Medicare ID numbers in order to get the law’s new benefits. In other states, seniors have been asked for personal information in order to get their new “Medicare ID cards.”

These are old crimes with a new spin. Every year, Medicare, Medicaid and private insurance companies each pay out billions of dollars in fraudulent claims. To cover these claims, we all pay what amounts to a health care fraud tax in the form of higher premiums.

Now, some of these criminals see health insurance reform an opportunity to launch new schemes.

My message to them today is this: there has never been a worse time to try to steal Americans’ health care dollars.

What these criminals may not know is that the Affordable Care Act is not just about making our health insurance system work better for families. It’s also contains some of the strongest anti-health care fraud provisions in American history.

Under this new law, we’re going to attack fraud at every stage of the process. First, we’re going to strengthen the screenings for health care providers who want to participate in Medicaid or Medicare. The days when you could just hang a shingle and start submitting claims are over.

Next, we’re going to make it easier for law enforcement to see health care claims data from different government agencies in one place. Under the old system, it was as if police officers in one town weren’t talking to the officers in the next town over. Giving law enforcement agents access to the big picture will help them identify suspicious patterns in claims data that can indicate fraud.

Third, we’re going to increase the penalties for fraud. When you commit Medicare or Medicaid fraud, you’re stealing from every US taxpayer and you should be punished accordingly.

Fourth, we’re going to provide new resources to get more boots on the ground to fight fraud in communities across the country – altogether, we’re adding an extra $600 million over the next ten years. When experts have studied our anti- fraud programs, they’ve found that they actually pay for themselves in money returned to taxpayers – often may times over. That means going after fraud is one of the best investments we can make.

These are just a few of the anti-fraud provisions in the Affordable Care Act. Added together, here’s what the changes look like from the perspective of a potential criminal: it will be harder to submit false claims; you’re more likely to get caught if you do; and when you get caught, you’re going to get a much tougher punishment.

That’s a big deterrent. And that’s why we believe the Affordable Care Act will not only allow us to identify and prosecute more episodes of health care fraud – we believe it will also help us prevent fraud from happening in the first place.

What’s going to make these steps even more effective is that we’re building on a strong foundation. Over the last 15 months, the President has led a push to fight fraud and strengthen program integrity across the government. This January for example, Attorney General Holder and I hosted the first ever National Health Care Fraud Summit. For the first time ever, we brought together government, law enforcement, and private insurance companies to share their best strategies for fighting fraud. Out of that conversation, we developed a list of next steps that we are already following up on.

The Fraud Summit was made possible partly by the great progress we made in 2009 with the creation of our joint HHS- DOJ HEAT Task Force. This first-time-ever Cabinet level partnership between HHS and DOJ has led to vastly improved coordination of our anti-fraud efforts across government and the addition of new Medicare fraud strike force teams in health care fraud hubs like Detroit and Houston. To learn more about this agenda and our results, I encourage you to visit our website

Today, our department and the Justice Department are releasing a report to Congress that shows just how impressive those results have been.

To talk a little more about that report and our interdepartmental fraud-fighting efforts, I’d now like to introduce a great defender of the American people and our partner in fighting health care fraud, Attorney General Eric Holder. Attorney General Holder…