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Health-care fraud crackdown nets $4.1b. Is that a lot?

Officials say nearly $4.1b was recovered last year in the health-care fraud crackdown, an Obama priority, but it's unclear if that reflects the success of law enforcement or the magnitude of the problem. 

By Staff writer / February 14, 2012

Health and Human Services (HHS) Secretary, Kathleen Sebelius, accompanied by Attorney General Eric Holder, speaks during a news conference to announce the new Health Care Fraud and Abuse Control Program Report, Tuesday, at HHS in Washington.

Manuel Balce Ceneta/AP

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The federal government recovered nearly $4.1 billion last year in an escalating, nationwide crackdown against health-care fraud, Obama administration officials announced Tuesday.

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Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder made the announcement in Washington as they released an annual report on health-care fraud enforcement.

The report shows a sharp increase in the amount of fines and restitution recovered from health-care scams during the Obama administration.

During President Bush’s eight years in office, nearly $1.6 billion was recovered on average each year by federal agents and prosecutors. In contrast, the Obama administration has recovered an average $3.6 billion per year during each of the past three years.

“These accomplishments reflect this administration’s ongoing and intensive efforts to protect the American people and to safeguard precious taxpayer dollars,” Attorney General Holder said.

“It is just one of many ways this administration is working to help the American people at a time when budgets are tight,” he said.

The announcement comes as the president’s health-care reform law – the Affordable Care Act – is under siege among Republicans in Congress and at the US Supreme Court, where lawyers for 26 states will argue next month that it is unconstitutional.

Fighting health-care fraud is essential in an administration that is seeking to dramatically increase the level of federal control over the nation’s health insurance system.

But it is unclear from the report to what extent the increased recoveries are a function of more efficient law enforcement or simply the rampant nature of fraud against the government. Estimates are that health-care fraud diverts more than $60 billion a year from public health care to criminal enrichment.

Administration officials insist they are bringing fraud, waste, and abuse under control.

“We are regaining the upper hand in our fight against health-care fraud,” Secretary Sebelius said. “It has never been harder to rip off Medicare and Medicaid, as it is today,” she said.

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