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Affordable Care Act recovers record amount from healthcare fraud

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In a report released on Wednesday in Washington, D.C. by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice (DOJ), the agencies announced that in the 2013 fiscal year the Affordable Care Act, also known as 'Obamacare,' was in part responsible for the record-breaking $4.3 billion recovery of funds lost due to Medicare and Medicaid fraud.

Over the past four years approximately $16.61 billion has been recovered from such fraud, a 219% increase over the previous four- year period’s recovery of $7.57 billion.

The savings is a return of $8.10 for every dollar used to fight Medicare and Medicaid fraud.

In a White House blog announcing the findings, HHS Secretary Kathleen Sebelius and U.S. Attorney General Eric Holder wrote, “Crime doesn’t pay when it comes to defrauding Medicare or Medicaid. But our crime-fighting efforts do.”

They later added, “Our ultimate goal, of course, is to prevent any taxpayer dollar from going to waste. We have more to do to reach that goal. But today’s report shows that we’re making substantial and significant progress in the fight against health care fraud.”

“The Department of Health and Human Services and The Department of Justice Health Care Fraud and Abuse Control Program Annual Report for Fiscal Year 2013” noted that the recovery of funds was due to 1,013 investigations involving 1,910 people in 2013. Out of these defendants, 718 were convicted.

At the end of FY2013 the DOJ had 1,079 health care fraud queries and investigations still open.

Unfortunately, due to the sequestration of $30.6 million in funds for the Health Care Fraud and Abuse Control Program (HCFAC) in 2013 fewer resources were available to recover more from Medicare and Medicaid fraud perpetrated by various criminal organizations and individuals.

Republicans in the U.S. House of Representatives and in the U.S. Senate in the past have lobbied for and continue to lobby for sequestration cuts to programs like HCFAC and others in an attempt to undercut benefits and positive programs provided by the Affordable Care Act.