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February 9, 2022
David Burda
Economics Innovation Policy

Fighting Fraud Instead of Election Results

What a difference an administration makes, right? Correlation isn’t causation, but it sure seems like the U.S. Justice Department under President Biden is a lot more interested in fighting healthcare fraud than it was under the previous person who occupied the White House. Shocking, I know. 

On Feb. 1, the Justice Department released its annual tally of false claims settlements and judgments for the most recently completely federal fiscal year. You can download the FY 2021 numbers here.  

Here are the highlights. In FY 2021: 

  • All civil fraud and false claims settlements and judgment for all agencies, including HHS, more than doubled to almost $5.7 billion from about $2.3 billion in FY 2020
  • Healthcare civil fraud and false claims settlements and judgments for HHS only more than doubled to nearly $5.1 billion from about $1.9 billion in FY 2020
  • And healthcare represented 89.7 percent of all settlements and judgments compared with 83.3 percent in FY 2020

The $5.7 billion all-settlement figure was the second-highest total after the $6.2 billion recorded by the Justice Department in FY 2014. And the $5.1 billion healthcare-only figure was the highest ever recorded by the Justice Department, far eclipsing the previous record of $3.1 billion in FY 2012.

“The department’s vigorous pursuit of health care fraud prevents billions more in losses by deterring others who might try to cheat the system for their own gain,” the Justice Department said in its press release announcing the new figures. “In many cases, the department’s efforts also protect patients from medically unnecessary or potentially harmful actions.”

Good. In previous fiscal year press releases, the agency pretty much said the same thing. But this time, it had the numbers to back it up. 

I noted the agency’s laughable gaps between its powerful fraud-fighting rhetoric and its actual weak fraud-fighting record in two previous blog posts: 

Seems only fair to give the Justice Department its due after criticizing its lame efforts the past two years. 

When you’re busy trying to overthrow the duly elected government of the United States, fighting fraud in the now $4.5 trillion healthcare industry drops to the bottom of your to-do list. When you’re not, you actually have time to do your job—in this case, for all taxpayers and consumers of healthcare goods and services in the U.S. 

Keep up the good work.

Thanks for reading.

About the Author

David Burda

David Burda began covering healthcare in 1983 and hasn’t stopped since. Dave writes this monthly column “Burda on Healthcare,” contributes weekly blog posts, manages our weekly newsletter 4sight Friday, and hosts our weekly Roundup podcast. Dave believes that healthcare is a business like any other business, and customers — patients — are king. If you do what’s right for patients, good business results will follow.

Dave’s personnel experiences with the healthcare system both as a patient and family caregiver have shaped his point of view. It’s also been shaped by covering the industry for 40 years as a reporter and editor. He worked at Modern Healthcare for 25 years, the last 11 as editor.

Prior to Modern Healthcare, he did stints at the American Medical Record Association (now AHIMA) and the American Hospital Association. After Modern Healthcare, he wrote a monthly column for Twin Cities Business explaining healthcare trends to a business audience, and he developed and executed content marketing plans for leading healthcare corporations as the editorial director for healthcare strategies at MSP Communications.

When he’s not reading and writing about healthcare, Dave spends his time riding the trails of DuPage County, IL, on his bike, tending his vegetable garden and daydreaming about being a lobster fisherman in Maine. He lives in Wheaton, IL, with his lovely wife of 40 years and his three children, none of whom want to be journalists or lobster fishermen.

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