DOJ steps up its fraud enforcement efforts

The number of criminal health care fraud cases prosecuted by U.S. Attorney’s Offices has more than tripled since 1993, according to a new study conducted by researchers at Syracuse (NY) University. In addition, in 1997 (the most recent year studied by the report), more than $1 billion was returned to the Medicare trust fund as a result of civil and criminal fines, judgments, and settlements.

Also in 1997, DOJ opened more than 1,400 criminal health care fraud cases, achieving a conviction rate of 87%. The percentage of convicted defendants who actually saw jail time was 54%.