The federal government recovered about $1 billion less in healthcare fraud and waste investigations in 2014 compared to the year before, with deep cuts from sequestration having an impact.
The federal government recovered $3.3 billion in the 2014 federal fiscal year from healthcare fraud judgments and settlements and fines from other fraud cases surrounding Medicare, Medicaid and other federal healthcare programs, according to a report from the Department of Justice and Department of Health and Human Services.
That figure is about $1 billion below the $4.3 billion collected in fiscal 2013. The federal fiscal year runs from the end of September to the beginning of October the next year.
The settlements mainly come from people trying to defraud Medicare or Medicaid in some way. For instance, the owner of a Miami nursing services clinic was sentenced to 12 years in prison for billing Medicare for $7 million in medical services that were either unnecessary or weren’t performed.
While the report doesn’t go into the drop-off, it does recount the effect of sequestration spending caps.
A total of $31.5 million was sequestered from the agencies’ Health Care Fraud and Abuse Program last year, for a combined total of $62.1 million over the past two years. The program received $1.5 billion in funding in 2014, which is divided amongst the multiple agencies within HHS and DOJ, according to the report.
Since the fraud program was created back in 1997, federal agencies have gotten nearly 30 billion from fraud and abuse cases.
The sequestration was created in the 2011 Budget Control Act and has been in effect since 2013. It caps spending increases for both defense and non-defense spending across the federal government.
