Feds Recover $2.5 Billion from Health Care Industry Fraud in 2018

That is just the money recovered in successful health care fraud cases. Imagine how much more goes undetected!
Justice Dept. logo
Here is the news of the Department of Justice’s annual report for 2018 for legal judgements under the federal False Claims Act. (Fascinating! the Act has been around since the Civil War.)
I know this might sound pretty boring, but you need to know about it especially as some of the successes come from “whistleblowers” who are able to make some serious money while unearthing fraud in primarily (in this case) the health care sector.
So, if you work for a doctor or hospital and notice some strange financial transactions, or see something suspicious on your Medicare statements, keep this in mind!
From a report by the law firm Holland & Knight:

In December 2018, the U.S. Department of Justice (DOJ) released its annual statistics for its civil False Claims Act (FCA) and fraud cases from the fiscal year ending Sept. 30, 2018 (fiscal year 2018). The DOJ reports it recovered $2.8 billion in settlements and judgments for Fiscal Year 2018. Of the $2.8 billion recovered in fiscal year 2018, $2.5 billion involved the healthcare industry—the ninth consecutive year that the DOJ’s civil health care fraud settlements and judgments have exceeded $2 billion.
[….]
qui tam suits
….the FCA is used by the U.S. government to combat healthcare fraud and also serves as the primary civil remedy for redressing false claims involving federal government contracts, grants, and federally-funded programs.
FCA cases can originate in one of two ways: (1) actions brought by the DOJ, or (2) actions brought by whistleblowers, known as relators, who are entitled to a portion of any proceeds recovered through settlement or judgment. In the latter actions, called qui tam actions, the case is filed under seal and the DOJ is given a period of time to evaluate the allegations and decide whether to intervene (i.e. take over the case). If DOJ declines to intervene, the relator may proceed with the action and potentially receive a greater cut of the recovery.
[….]
…in the healthcare industry newly brought qui tam cases are down while non-qui tam cases are slightly up.
[….]
The increase in government-initiated healthcare cases may be attributable to enforcement initiatives such as the nationwide Medicare Strike Force Teams. These teams, which are scattered throughout the United States, focus on criminal and civil health care fraud.

Feds are increasing the number of US Attorneys in key hot spots!

 

The trend line for government-initiated FCA actions should increase over the next few years. DOJ recently added a cadre of new affirmative civil enforcement attorneys, whose role will include initiating cases under the FCA. The new Assistant United States Attorneys (AUSAs) are being placed throughout the country—and offices where there is a hotbed of government contracting and healthcare are receiving more than one new AUSA. While most U.S. Attorney’s Offices will receive one additional AUSA for affirmative civil enforcement, DOJ announced that offices such as Colorado, Middle District of Florida, Southern District of Florida, Massachusetts, New Jersey, Eastern District of New York, Southern District of New York, and Eastern District of Virginia, would receive two.

More here.

question markThis got me thinking.  Have you seen any funny money business going on with the US Refugee Admissions Program and the Dept. of Health and Human Services contractors?
If so, think about this avenue to bring attention to possible fraud! You might actually make a few bucks in the process!

Afterthought:  I need to be sure to let new readers know why I write this blog, here is my “welcome” post from January first.

Limbaugh: Pelosi's Message is that she and the Democrats Hate Trump and YOU!

If the Democrats’ intransigence on border security for which a small amount of money is required for a barrier along our southern border (as another caravan is on the way) puzzles you, radio talk show host Rush Limbaugh describes this as a much larger pivotal moment for America.
We all know the Democrats depend on immigrant voters—they want more of them and want the ones they have to be happy (with their social services!).  The immigrant numbers beef-up certain Congressional districts controlled by Dems as well.
In addition, the business community wants the cheap “new American” laborers and both the Dems and some Republicans are working to provide them with an uninterrupted supply of those.
Yeh, we get that.

Of course we have no idea what the President will say to the nation today at 3 p.m., but he can’t give an inch because as Limbaugh said on Thursday, the stakes are too high.

rush and nancy
Important day in US history? What will the President say today?

 
(An aside:  As you know I watch the phony baloney at CNN each morning to see where the Leftwing media is going on any given day. Yesterday they were all a tither (we got him now!) about the now discredited BuzzFeed story. Today they quietly, and not as their lead story, reported the bombshell of last evening that Mueller’s team has said the story is wrong. Of course the reporting yesterday gives all of us more evidence of the media bias against this President and frankly against us!)
What follows is a transcript of the Rush Limbaugh show on Thursday, hat tip: Paul.
For all of us wondering how Nancy Pelosi could even have thought going on a foreign taxpayer-funded junket right now made any political sense, Rush’s comments make it clear.  To heck with the poor government workers who aren’t being paid, creating chaos and strife and making sure Trump loses is key to the Democrat’s (and the Swamp’s!) future.
I know it is long and although Rush (effectively) repeats his points, read it all. Added emphasis is mine.
 

RUSH: I want to try to have as many people as possible understand what is really going on here.
And the first thing that I have to tell you, and I mean this from the bottom of my heart, and I’m not exaggerating, and I’m not trying to be provocative, and I’m not trying to make anybody mad. Nancy Pelosi doesn’t care one whit about the hardships of anybody or anything during this shutdown. Nancy Pelosi and the Democrat Party care about one thing: making sure that nobody like Donald Trump ever tries this again.
swamp hates you
The message being sent here is that somebody Washington disapproves of being elected president is going to be shut down and will not be cooperated with and nothing will ever get done because the objective here is twofold. It’s to get rid of Donald Trump and then to paralyze Donald Trump. Paralyze him first, get rid of him, and then send the signal, you Republicans better never, ever send somebody like this, because it’s gonna end up being like this every damn time, ’cause we’re not gonna do business with somebody like this. We’re not gonna let somebody like this ever be legitimate.
That’s what this is. It is nothing about the shutdown. It’s nothing about the hardships that are being faced. It’s not even about the wall! Pelosi and the Democrats, as you said, have supported a wall in the past. This is about making sure, about doing everything they can do to make sure that this guy who they despise does not have one demonstrable success so that nobody like him will ever, ever try this again.
This is a long-term message to everybody outside Washington, everybody outside the Washington political class, the elites, whatever, you’re not welcome here, and we will damage whatever it takes to make sure none of you ever end up here again. And those of you who voted for this, don’t you ever do this again. Your votes are wasted. You’re not gonna get one thing you want, you’re not gonna get anything, and we’ll be glad for all this destruction to send the message that you don’t get to do this.
BREAK TRANSCRIPT
RUSH: Right after I just made my point to the last caller and to — let me briefly repeat it. Nancy Pelosi and most of the Democrats have a singular message in all this, and it has nothing to do with the wall or with the money or any of this. We have two years until the — actually less — ’til the next presidential election. And that’s all this is.
This is Pelosi and the Democrats swearing that no matter what Trump wants, if it’s gonna make him look good, presidential, if it’s gonna help the Republican Party, it isn’t happening. But there’s more than that. This is really about Nancy Pelosi — I cannot — I’ve tried to describe this numerous times. I’ve tried a bunch of different ways. I cannot, I don’t believe, adequately describe for you how personally despised and resented Donald Trump is and those of you who voted for him.
I mean, folks, there is visceral hatred. Donald Trump being elected president, not just beating Hillary, but just being elected is the equivalent of a killer virus being released in Washington. And they have stop it. They have to kill the virus. That’s Trump and you who voted for him. This was never supposed to happen. The governed are never supposed to have this much influence over what happens in that town. You’re not supposed to have anywhere near this much say over what your government does. You’re not supposed to have much say at all.
You get to vote, but beyond that, (raspberry) you. And Trump brought you with him to Washington. Trump is doing everything he can to keep every promise he made. I cannot tell you how offensive that is to them. I can’t tell you how disruptive it is. I can’t tell you how they are livid about it. And this whole government shutdown and the intransigence that Pelosi has, the unwillingness to even negotiate anything here is purely and simply about making sure that none of this is ever seen as legitimate.
It’s always, if she has her way, gonna be seen as one of the most oddball things that ever happened in American history that was a pure quirk of fate, it was abnormal, it was not supposed happen, and because of that, it’s not going to be legitimized. The previous two years have been all about that, not legitimating President Trump, his agenda, his voters, especially now, ’cause everybody’s racing to get ready for the 2020 presidential election.
As far as Pelosi and her side are convinced, it’s all about getting rid of Trump and it’s all about erasing these past two years, it’s about erasing the two years of the campaign that led to Trump. And it’s personal. And it is literally governed by a visceral hate. This is why there is no compromise here. Some of you are saying, “Well, how do you think Trump can win?” I think the longer this goes on, the more people are gonna see this for what it is. The longer it goes on, the greater opportunity for people to finally see the Democrat Party as they are, who they are and so forth. Not a slam dunk.
But there is no way in my book they get away with delegitimizing you and your votes in 2016. There’s no way they get away with essentially saying, “You don’t really count. You count on Election Day if you vote the right way, but other than that we couldn’t care less about you.” The Democrat Party agenda is aimed at undermining everything you believe in. The Democrat Party is championing everybody who isn’t you. Sanctuary cities, open borders, anything that disrupts the foundational structure of this country — and I mean foundational, from the days of the founding — that’s their agenda.
So here’s the tweet from Charles Grassley, senator from Iowa. “Good news for Iowa farmers: USDA will reopen 37 Farm Service Agency offices in Iowa during partial govt shutdown. Seems to me Trump admin trying to help ease burden of shutdown & Pelosi trying to maximize + refusing to negotiate or even show up.”
Exactly! Exactly! I got this tweet during the break, after I had made my original point, but he’s exactly right. Pelosi is trying to maximize the burden on everybody so you’ll not never (sic) do this again. She wants you getting hurt! She wants you suffering! She wants you thinking you’re responsible for this. You elected Trump! This is what happens when you send somebody to Washington they don’t prove of. You deserve to be suffering, damn it, for this act of insolence of yours. It’s bad enough when you elect a traditional Republican like George W. Bush, but this? You’re going to pay.
And Grassley here is exactly right. And it is about exactly that, folks. It’s, “I wish Pelosi would negotiate, we need to put the air traffic controllers back, certainly some –” Pelosi doesn’t care about the air traffic controllers! She doesn’t care! In fact, the more chaos and the more disruption, the bigger the opportunity for her and others like her and her party.

Creating chaos and disruption is a tired old strategy of the Communists and Socialists as they attempt to undermine governments, but it’s a long subject for another day!
More from Rush here.
Sure hoping and praying the President stays strong this afternoon!