HHS Releases Health Care Fraud and Abuse Control Program Annual Report for 2006

On February 12, 2008, the Department of Health and Human Services (HHS) and Department of Justice (DOJ) released the Health Care Fraud and Abuse Control Program Annual Report for FY 2006 (Annual Report). 

According to the Annual Report, the Federal government won or negotiated approximately $2.2 billion in judgments and settlements, and attained additional administrative impositions, in health care fraud cases and proceedings during fiscal year (FY) 2006.  During FY 2006, the Medicare Trust Fund also received transfers of approximately $1.5 billion as a result of these efforts (and those of preceding years).  Further, the Annual Report indicates that during FY 2006:

• U.S. Attorneys' Offices opened 836 new criminal health care fraud investigations involving 1,448 potential defendants
• Federal prosecutors had 1,677 health care fraud criminal investigations pending, involving 2,713 potential defendants, and filed criminal charges in 355 cases involving 579 defendants
• a total of 547 defendants were convicted for health care fraud related crimes
• DOJ opened 915 new civil health care fraud investigations and had 2,016 civil health care fraud investigations pending

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established the national Health Care Fraud and Abuse Control Program (HCFAC).  Under the joint direction of the Attorney General and HHS (acting through HHS' Office of Inspector General), the HCFAC program is designed to coordinate Federal, State and local law enforcement activities concerning health care fraud and abuse.  HIPAA requires that HHS and DOJ detail the amounts deposited and appropriated to the Medicare Trust Fund and the source of such deposits in the Annual Report.