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HCFAC Report Press Conference

February 14, 2012
Washington, DC

Good morning.  I want to thank you all for joining us for an important announcement about how the Obama Administration’s historic anti-fraud efforts are returning record funds to taxpayers, strengthening Medicare and Medicaid, and putting criminals on the defensive across America.

Today, we are releasing a report, which shows that our work to take on the criminals who steal from Medicare and Medicaid is paying off: we are regaining the upper hand in our fight against health care fraud.

As this report shows, our anti-fraud efforts recovered $4.1 billion last year.  That’s up 58 percent from 2009.  We opened new cases with more than 2,500 potential defendants.  That’s up 43 percent from 2009.

And today’s report also shows that going after health care fraud continues to be one of the best investments we can make as a country.  Over the last three years, for every dollar we’ve spent, we’ve put more than $7 back in the hands of American taxpayers.

We would not be making this announcement if President Obama had not chosen to put a new focus on health care fraud.  When he came into office, we were, frankly, falling behind.  Scams were getting bigger and more sophisticated.  Criminals were being more creative and going after larger sums.  They were evolving, and we needed to catch up.

Over the last three years, we’ve done that.  As you’ll hear from Attorney General Holder, we now have nine strike force teams in fraud hot spots around the country – teams that are responsible for a significant share of the takedowns covered in the report we’re releasing today. 

We’ve also strengthened cooperation between our departments and outside law enforcement.  And through the Affordable Care Act, we’ve put more boots on the ground to catch criminals and established tougher sentences for those who do get caught.

But from the start, we also knew that more resources alone would not be enough.  If we wanted to turn the tide on fraud, we also had to get away from our old pay and chase model, which often left us playing catch-up with criminals who could set up a fraudulent operation, bill Medicare for thousands of dollars, and be long gone by the time we showed up.

So over the last three years, we’ve also taken historic steps to make it harder to commit fraud in the first place.  That starts with some common sense rules that are long overdue.  First, if you’re a provider who’s been terminated from Medicare or a state’s Medicaid program, you’ll now be terminated from all Medicaid programs.  Second, if you lie on your application, we’re going to exclude you from these programs.

We’re also putting special protections in the areas where fraud is most likely to occur.  In particular, durable medical equipment vendors and home health care providers will now face a far more rigorous screening process.  The days when you could rent an office, acquire some Medicare numbers, and start sending out claims for motorized wheelchairs that people didn’t need and never got are coming to an end.

Perhaps most importantly, we’re putting in place systems that can identify suspicious claims in real time.  Now, just as your credit card company freezes your account when it’s used to buy ten flat screen TVs across the country, we have the technology to stop suspicious claims payments before they go out.

Many of these changes were made as part of the Affordable Care Act, another reason why it’s the most significant anti-health care fraud law in American history.  And together, they mean that it has never been harder to rip off Medicare and Medicaid than it is today.

They also mean that the numbers in today’s report only capture part of the impact we’ve had.  For every criminal who gets caught and is counted in these statistics, there may be many others who thought about committing fraud, looked at the new protections in place, and decided it wasn’t worth it.

As we move forward, we will continue to be guided by our sacred responsibility to safeguard taxpayer dollars.  Our goal is, and should always be, to not have a single dollar go to waste.  That means continuing to crack down on fraud.  But it also means taking additional steps to reduce improper payments, such as a new rule we’re proposing today that will ensure, for example, that when providers receive two payments for the same claim, they act quickly to return the extra money.

These reforms are especially important when we’re talking about programs like Medicare and Medicaid, which nearly one in three Americans depend on every day.  These are the programs that ensure that kids can get their checkups, moms can have healthy pregnancies, people with disabilities can live with dignity, and seniors don’t have to worry about going broke because of a hospital bill.  And today, those programs are stronger because of the results we are announcing this morning.

There is more work to be done.  But today’s report shows that we are moving in the right direction.  It sends a clear message to the American people that we will do whatever it takes to make sure their tax dollars are spent wisely.  And it sends a clear message to criminals that the days when stealing from Medicare or Medicaid was easy money are over.

Thank you.  And now, I’d like to turn it over to Attorney General Holder.