Justice Recovers $5B from Healthcare Fraud Cases in 2021

By Staff Reporters

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The Justice Department’s (JD) efforts returned almost $1.9 billion to the federal government or paid it out to private individuals. Of that money, about $1.2 billion went to the Medicare trust fund. About $98.7 million in federal Medicaid money was transferred to CMS. The JD opened 831 criminal healthcare fraud cases last year. Federal prosecutors filed criminal charges in 462 cases involving 741 defendants. A total of 312 defendants were convicted of healthcare fraud during the year. The JD opened 805 civil healthcare fraud investigations and had 1,432 civil healthcare fraud matters pending at the end of last year. 

HHS Office of the Inspector General (OIG) investigations resulted in 504 criminal actions against individuals or entities accused of Medicare- and Medicaid-related crimes. The OIG filed 669 civil actions, which included false claims and unjust-enrichment lawsuits filed in federal district courts, and civil monetary penalties. The OIG excluded 1,689 individuals and entities from participating in federal healthcare programs, including Medicare and Medicaid. 

Source: Andrew Cass, Becker’s Hospital Review

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