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Fact Sheet: Department of Justice Efforts to Combat Health Care Fraud and Abuse

al use. Rodriguez Sanchez did not require a

prescription or physical examination by a licensed physician from any of

his customers. He retrieved the money sent by the customers at a Western

Union location in Mexico, but shipped the drugs from Southern California

to customers throughout the United States, including the Philadelphia


Recovering Payments through Civil Enforcement:

Also in FY 2007, the Department continued its civil enforcement efforts under the False Claims Act to combat fraud involving a wide spectrum of health care providers and suppliers including doctors, dentists, hospitals, pharmacies, durable medical equipment providers, home health providers, and pharmaceutical and device manufacturers.

-- During FY 2007, the Department opened 776 new civil health care fraud

investigations, and had 743 civil health care fraud investigations

pending at the end of the fiscal year.

-- During FY 2007, the federal government won or negotiated approximately

$1.8 billion in judgments and settlements, and it attained additional

administrative impositions in health care fraud cases and proceedings.

-- The Medicare Trust Fund received transfers of approximately $797 million

during this period as a result of these efforts, as well as those of

preceding years, in addition to $266 million in federal Medicaid money

separately transferred to the Treasury as a result of these efforts.

Some recent civil enforcement actions include:

-- Baptist Health South Florida Inc.: In May 2008, Baptist Health South,

headquartered in Miami, paid $7,775,000 to settle claims that it

violated the False Claims Act and the Stark Statute between 2003 and

2005, by paying excessive compensation to an oncology group that was a

source of patient referrals to two o

SOURCE U.S. Department of Justice
Copyright©2008 PR Newswire.
All rights reserved

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