National summit on coordinated effort to fight health care fraud

Summit Brings Private and Public Sectors, Law Enforcement Together to Fight Fraud

Attorney General Eric Holder and U.S. Department of Health and Human Services Secretary Kathleen Sebelius today joined private sector leaders, law enforcement personnel and health care experts for a landmark National Summit on Health Care Fraud. The summit is the first national gathering on health care fraud between law enforcement and the private and public sectors and is part of the Obama Administration's coordinated effort to fight health care fraud.

"Health care fraud affects all Americans and demands a coordinated, national response," said Attorney General Holder. "HEAT (the Health Care Fraud Prevention & Enforcement Action Team) has proven that better collaboration is the key to combating these crimes, recovering stolen resources, and protecting essential Medicare and Medicaid dollars. We welcome the private sector's participation in this work – together, I'm confident we can make great strides in identifying, preventing, and punishing health care fraud."

"The Obama Administration has zero tolerance for health care fraud and abuse," said Secretary Sebelius. "Building on the work we have accomplished through HEAT, I am pleased to announce here at the National Summit on Health Care Fraud that the President's FY 2011 Budget being unveiled next week will include historic support for anti-fraud efforts that will save billions over 10 years. He will call for increased investments in programs that have a proven record of preventing fraud, reducing payment errors and returning funds to the Trust Funds."

The National Summit features discussions of innovative ways to eliminate fraud and abuse in the U.S. health care system. The morning program includes remarks from Attorney General Holder, Secretary Sebelius, Congressman Ron Klein and James Roosevelt Jr. CEO of Tufts Health Care, who will address the important role of the private sector in fighting fraud. Later, officials from the Departments of Justice and Health and Human Services will participate in a panel discussion about methods being used to prevent and crack down on health care fraud.

In the afternoon, workgroups will focus on the:

• Use of technology to prevent and detect health care fraud and improper payments.
• Role of states in preventing health care fraud.
• Development of effective prevention policies and methods for insurers, providers and beneficiaries.
• Effective law enforcement strategies.
• Measuring health care fraud, assessing recoveries and determining resource needs.

Summaries of the workgroup discussions will be compiled in a publicly available report that will help strengthen the federal government and private sector's work to deter health care fraud.

"Health care fraud isn't just a government problem. Criminals don't discriminate and they are stealing from Medicare, Medicaid and private companies at an unacceptable rate," said Sebelius. "We have a shared interest in stopping these crimes and today's summit brought us together to discuss how we can all work together to fight fraud."

The National Summit is the latest initiative of HEAT, which was announced by Attorney General Holder and Secretary Sebelius in May 2009. The partnership between the two departments has focused efforts to reduce and prevent Medicare and Medicaid fraud through enhanced cooperation. Expansion of the Medicare Fraud Strike Force operations is a key component of the HEAT taskforce. Strike Force Teams initially began in Miami in 2007 and expanded to Los Angeles in 2008. Since the formation of HEAT, the Strike Force has expanded to Detroit; Houston; Brooklyn, N.Y.; Baton Rouge, La. and Tampa, Fla..

To date, Strike Force Teams have obtained indictments of more than 500 individuals and organizations that collectively have falsely billed the Medicare program for more than one billion dollars.