Health Care Fraud Prosecutions Up 78% Since Launch Of Affordable Care Act

It’s been more than two years since the Affordable Care Act was signed into law, and while the Supreme Court mulls over the reform’s future, a look back over the last couple years shows a sharp increase in health care-related criminal fraud charges.

According to numbers compiled from the Justice Dept. and the Dept. of Health & Human Services, the number of people charged with health care fraud has jumped up 78% from 803 in fiscal year 2009 to 1,430 in fiscal year 2011.

A good chunk of this success has to do with the Health Care Fraud Prevention and Enforcement Action Team (which goes by the name “HEAT” because “HCFPEAT” does not conjure up images of Al Pacino and Robert DeNiro involved in a shoot-out). HEAT pre-dates the signing of the Affordable Care Act, but in just the last few months it brought charges against 150 people alleged to be responsible for around $1 billion in fraud.

HEAT’s Medicare Fraud Strike Force recently charged more than 100 individuals in seven cities for their alleged participation in Medicare fraud schemes involving approximately $452 million in false billing.

In addition to increasing prosecutions on fraud charges, the Affordable Care Act also increased federal sentencing guidelines for health care fraud offenses by up to 50% for crimes involving more than $1 million in losses.

Another program that pre-dates the Affordable Care Act, the Health Care Fraud and Abuse Control Program (HCFACP, because not everything can have cool initials), has seen a 27% increase in convictions during the last two years. Additionally, since 2009, HCFACP has reportedly returned $10.7 billion to the Medicare Trust Funds.

“We are committed to using these new tools to fight Medicare and other health care fraud, and we are getting results,” writes White House Deputy Chief of Staff Nancy-Anne DeParle.