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DOJ: $1.8 billion negotiated in settlements in 2003

Compliance Monitor, February 23, 2005

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The federal government won or negotiated more than $1.8 billion in judgments and settlements in healthcare fraud matters, the U.S. Department of Justice announced in its Health Care Fraud and Abuse Control Program annual report for fiscal year 2003, released February 7.

"In its seventh year of operation, the program's continued success again confirmed the soundness of a collaborative approach to identify and prosecute the most egregious instances of healthcare fraud, to prevent future fraud or abuse, and to protect program beneficiaries," the report announced in its executive summary.

Of the $1.8 billion negotiated, the government collected more than $1.4 billion and distributed more than $1 billion, with another $500 million scheduled to be collected and/or distributed in early 2004. Of the money distributed, approximately $723 million was paid to the Medicare Trust Fund and $151.6 million was returned to CMS as the federal share of Medicaid restitution.

The report also includes the following highlights for fiscal year 2003:

• 362 criminal indictments were filed in healthcare fraud cases
• 437 defendants were convicted for healthcare fraud-related crimes
• 231 civil cases were filed
• 3,275 individuals and entites were excluded from participating in the Medicare and Medicaid programs, or other federal healthcare programs

Click here to read the complete report.

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