Huff Post Business: Health Care Fraud Investigations Pulling In $8 for Every Dollar Spent


Earlier this month, the departments of Justice and Health and Human services announced they recovered nearly $8 for every dollar invested in anti-fraud efforts in 2012.


In particular, the hospital disclosed that it admitted patients for short stays – typically one or two days – that were not warranted by the patient’s medical condition, and thereby generated a larger reimbursement than was proper for each patient.   Of the $4.9 million to be paid by St. Joseph’s, $4.6 million will go the United States, and $152,406 will go to the state of Maryland, which is also a party to the agreement.

“The improper admission of patients for the purpose of obtaining increased reimbursement is a significant drain on the resources of federal and state healthcare programs,” said Stuart F. Delery, Principal Deputy Assistant Attorney General of the Justice Department’s Civil Division.   “This recovery reflects the Department’s continuing efforts to safeguard federal funds.”

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