The word fraud with a red circle crossing it out. The HEAT is on

The HEAT is on!

HEAT….which stands for the Healthcare Fraud Prevention and Enforcement Action Team is part of a nationwide government-sponsored effort to increase healthcare fraud enforcement efforts, and both organizations and providers have been feeling the squeeze.

According to the Department of Justice (DOJ) “Since their inception in March 2007, Strike Force operations in seven districts have obtained indictments of more than 850 individuals who collectively have falsely billed the Medicare program for more than $2.1 billion dollars.  In addition, HHS’s Centers for Medicare and Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.”

It is estimated that healthcare fraud costs the government and taxpayers $60-$100 Billion dollars per year, and with the present fiscal squeeze there is a huge push to recoup as much of this money as possible, but some industry insiders say that the aggressive actions of HEAT are not only targeting fraudulent providers, but those who are simply unknowing not in compliance with a portion of the myriad of healthcare regulations which are enacted every year.  It will be essential moving forward that every healthcare organization have a strong compliance awareness and that compliance in healthcare is an issue which is continually monitored.  Organizations can further benefit from having ongoing quality improvement programs that address healthcare compliance, and actively procure up to date financial risk analysis to gauge where their organization may be impacted.

For a small sample of the headline news regarding who HEAT has impacted, and what the repercussions have been follow the links below, I hope you find them as interesting as I did:

Brooklyn Neurologist found guilty of Health Care fraud

Houston Healthcare Company Guilty in 1.3 million dollar fraud case

53 individuals indited in Strike Force case

94 Doctors Criminally Charged for Billing Errors