Washington Post (02/13/12)
New tools that help authorities to uncover fraudulent Medicare claims helped authorities recover $4.1 billion in health care fraud judgments in 2011, according to the Department of Justice and the Department of Health and Human Services. That total is about 50 percent higher than 2009 and is credited to better screening of providers before they enter the system and tighter enrollment requirements. Investigators are also making site visits to make sure actual offices exist, while higher-risk providers must submit to fingerprint and background checks. The old process of paying claims first and then investigating suspicious ones needs to end, authorities say, as fraudsters have usually moved on to another provider ID or left the country by the time the fraud is uncovered. The government established strike force teams in fraud-prone cities like Miami, Detroit, and Los Angeles, and charged 323 defendants for more than $1 billion in fraud claims. The sentences for fraud are also longer, with the average rising to 47 months in 2011 compared to 42 months in 2010.

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