Wednesday, January 26, 2011

Drug Companies and Healthcare Providers Responsible for $4 Billion in Fraudulent Payments


The U.S. government said it recovered a record $4 billion in fines and fraudulent health- care payments last year from drugmakers, medical-equipment dealers and health-care providers.
The results for fiscal year 2010 fraud-fighting result from a crackdown by the Obama administration that enforcement officials plan to expand this year with tools created in the 2010 health law, the U.S. Health and Human Services Department said today.
“We want to make it possible to cut off the flow of funds to suspected criminals before they can take the money and run,” said Kathleen Sebelius, secretary of the agency, at a press conference.
The crackdown started two years ago, Sebelius said, with the creation of a joint program with the U.S. Justice Department. The agencies increased the number of local fraud task forces to seven from two, including areas such as Brooklyn, New York; Tampa, Florida; and Baton Rouge, Louisiana.
Cases included Allergan Inc., the Irvine, California, maker of the drug Botox, which was fined $600 million for improperly marketing the wrinkle-reducing drug; and London-based AstraZeneca LP, the recipient of a $520 million fine for improper marketing of antipsychotic drug Seroquel, the department said.
Expanding Efforts
The health law signed by U.S. President Barack Obama in March 2010 expands the government’s health-care fraud fighting efforts, Sebelius said.
The law lets the government withhold Medicare and Medicaid payments to health-care service providers that are under investigation, which the government couldn’t do previously, Sebelius said.
Medicare is the U.S. government insurance program for the elderly and disabled, while Medicaid serves the poor. The law can stop the addition of health providers to Medicare and Medicaid in places or service types where fraud has become prevalent.
The government will use screening software similar to the type used by credit card companies to spot fraudulent charges, according to a government summary of the rules.

SOURCE: Shatterlimits