Fraud By The Numbers Series
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Fraud By The Numbers 2023 – Sept. 16
As we highlighted in last year’s series, Medicare paid a total of $13.5 billion for medical equipment. The billions spent on these multiple and single-use devices have proven to be a ripe target for fraud: – In 2021, St. Jude paid $27 million for allegedly selling defective heart devices. – In the same year, two…
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Fraud By The Numbers 2023 – Sept. 15
In our September 2 post on the troubling decline in False Claims Act –recoveries in recent years, we highlighted the growing importance of declined False Claims Act cases in recovering government money lost to fraud. “Declined cases” are FCA cases brought by whistleblowers under the qui tam provision where the United States Government has “declined”…
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Fraud By The Numbers 2023 – Sept. 14
Medicare is a bit of a unicorn in today’s politics—an overwhelmingly popular government program. But it is becoming increasingly expensive, potentially threatening its popularity and viability. In 2022, Medicare benefit payments totaled $744 billion, almost three and a half times as much as in the year 2000 when they totaled just under $200 billion. This…
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Fraud By The Numbers 2023 – Sept. 13
The Centers for Medicare and Medicaid Services (CMS) releases extensive datasets that are important resources for fighting fraud on the government healthcare programs—and they could be doing even more to make their data publicly available. One dataset, Physician and Other Practitioners’ Services, shows a portion of Medicare Part B (which covers outpatient care) data for…
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Fraud By The Numbers 2023 – Sept. 12
It’s time to revisit the dismal numbers involving False Claims Act (FCA) enforcement in the defense industry. The Department of Defense (DOD) budget in fiscal year 2022 was $715 billion (with a B), up from $703.7 billion in 2021. If you take into account defense spending for agencies outside of the DOD, such as the…
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Fraud By The Numbers 2023 – Sept. 11
Yesterday we examined the amount of money involved in capital markets and the SEC’s resources to enforce the law. Today we want to look at an aspect of those markets that makes regulation in this area different than dealing with other types of fraud, especially in the historical context of regulating financial exchanges. In 1933,…
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Fraud By The Numbers 2023 – Sept. 10
The SEC says fighting fraud is its number one strategic goal in the Commission’s FY 24 Congressional Budget Justification and FY 22 Performance, Report, page 7. We try to examine if their resources match the mission. Despite the progress made by the SEC Whistleblower Program and efforts by the Commission in general, not nearly as…
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Fraud By The Numbers 2023 – Sept. 9
There has long been concern that kickbacks sway healthcare providers to make decisions based on personal greed, as opposed to patient need. But for years, healthcare providers have argued that even illegal payments from outside sources have no material impact on their medical decision-making. Some courts believed these arguments and dismissed cases alleging illegal kickbacks…
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Fraud By The Numbers 2023 – Sept. 8
Private equity investment in the healthcare space continues at a breakneck pace, resulting in profit-driven corporations living in the shadows of medical offices and hospitals around the country. As we reported last year, estimates of private equity deals in the healthcare space nearly tripled in value—from $43 billion to $124 billion—between 2010 and 2019. According…
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Fraud By The Numbers 2023 – Sept. 7
Last year during Fraud by the Numbers, we discussed the huge surge in telehealth usage during the COVID-19 pandemic. Medicare telehealth services skyrocketed from 840,000 provided in 2019, to 52.7 million provided from March 2020 to February 2021. Though we have moved past the COVID-19 pandemic shutdowns and returned to more regular in-person visits, ,…
