Nation's anti-fraud efforts paying off, Holder says

At a summit held yesterday in Boston, Attorney General Eric Holder said the nation's crackdown on health care fraud and abuse is paying off, and Health and Human Services Secretary Kathleen Sebelius talked about new approaches that are contributing to such successes. Meanwhile, a new analysis names big pharma as the nation's "biggest defrauder" under the False Claims Act.

The Associated Press: Holder: Health Care Fraud Work Reaping Dividends
Attorney General Eric Holder said Thursday an Obama administration crackdown on health care fraud is paying dividends, recovering more than $4 billion in Massachusetts alone during the past two years (Johnson, 12/16).

Reuters: U.S. Tries Smarter Approach To Health Care Fraud
The new approach is based on "predictive modeling," a combination of advanced analytics, linkage analysis, behavioral analysis and other statistical techniques. Sebelius compared the modeling tools to ones often used by banks or insurance companies — that might, for example, throw up a red flag if there are unusual patterns of usage on a person's credit card (Frasny, 12/16).

Milwaukee Journal Sentinel: Big Pharma Now Tops List Of Government Defrauders, Group Finds
The pharmaceutical industry has zoomed by the defense industry to become the biggest defrauder of the federal government based on payments obtained under the federal False Claims Act, according to an analysis by the group Public Citizen (Fauber, 12/16).

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This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.