HEAT Summit Seeks to Help Cure a Dying System: The Obama Administration and the Battle Against Health Care Fraud

 Lynn Nolan, Government Law Review member

             Approximately $125–175 billion are lost to fraud each year in both the private and public health care sectors.[1]  The FBI estimates that in fiscal year 2009, $75–250 billion were stolen from public and private healthcare programs through fraudulent billings alone.[2]  With the prevalence of health care fraud becoming more apparent the government is taking action to prevent and prosecute fraudulent activity.  President Obama has made combating health care fraud a priority of his administration by encouraging the development of innovative methods of preventing fraud and pursuing policy changes to facilitate reform.[3] 

            One of the Administration’s signature initiatives is the Health Care Fraud Prevention and Enforcement Action Team (HEAT), which is a collaborative task force derived from the Department of Health and Human Services (HHS) and the Department of Justice (DOJ).[4]  The HEAT task force was established on May 20, 2009 to aid in the identification of perpetrators of fraud in order to recover funds which have been stolen and prohibit perpetrators from abusing federally funded health care programs, such as Medicare and Medicaid.[5]  The latest initiative of HEAT was the National Summit on Health Care Fraud which was held on January 28, 2010.[6]  The National Summit was held to address the issue of health care fraud and promote the participation of the private health care sector in collaboratively fighting fraud to aid government efforts.[7]  Secretary Sebelius addressed the private sector in saying,

[h]ealth care fraud isn’t just a government problem.  Criminals don’t discriminate and they are stealing from Medicare, Medicaid and private companies at an unacceptable rate . . . [w]e have a shared interest in stopping these crimes and today’s summit brought us together to discuss how we can all work together to fight fraud.[8] 

Continue reading “HEAT Summit Seeks to Help Cure a Dying System: The Obama Administration and the Battle Against Health Care Fraud”