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Feds highlight fraud efforts for FY20

Feds highlight fraud efforts for FY20

WASHINGTON – The Department of Justice opened 1,148 new criminal health care fraud investigations in fiscal year 2020, according to an annual report published this week.

Federal prosecutors filed criminal charges in 412 cases involving 679 defendants. A total of 440 defendants were convicted of health care fraud-related crimes.

The DOJ also opened 1,079 new civil health care fraud investigations and had 1,498 civil health care fraud matters pending at the end of fiscal year 2020.

Investigative efforts by the Federal Bureau of Investigation resulted in more than 407 operational disruptions of criminal fraud organizations and the dismantlement of the criminal hierarchy of more than 101 health care fraud criminal enterprises.

Investigations conducted by Office of Inspector General at the Department of Health and Human Services resulted in 578 criminal actions against individuals or entities that engaged in crimes related to Medicare and Medicaid, and 781 civil actions, including false claims and unjust-enrichment lawsuits filed in federal district court, civil monetary penalties settlements and administrative recoveries related to provider self-disclosure matters.

The OIG also excluded 2,148 individuals and entities from participation in Medicare, Medicaid and other federal health care programs. 

The report highlights a number of investigations related to DME on pages 16-17.


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