The United States Departments of Justice and of Health and Human Services have issued the Health Care Fraud and Abuse Control (HCFAC) Program annual report for FY 2005.
During fiscal year 2005, the Federal government won or negotiated nearly $1.5 billion in judgments and settlements. The report also shows awards to qui tam relators totaling $137.8 million. The program had success in pursuing allegations of fraudulent drug pricing, kickbacks, pharmaceutical distribution fraud, and dialysis fraud.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established a comprehensive program to combat fraud committed against all health plans, both public and private. It required the establishment of a national Health Care Fraud and Abuse Control Program (HCFAC), under the joint direction of the Attorney General and the Secretary of the Department of Health and Human Services ( HHS) acting through the Department’s Inspector General (HHS/OIG). The HCFAC program is designed to coordinate Federal, State and local law enforcement activities with respect to health care fraud and abuse. The Act requires HHS and DOJ detail in an Annual Report the amounts deposited and appropriated to the Medicare Trust Fund, and the source of such deposits.