Although Republicans had asked Gov. Chris Christie of New Jersey to deliver their response to President Barack Obama’s State of the Union address Tuesday night, he declined the offer, The Auditor/The Star-Ledger of New Jersey reported.
Christie confidant William Palatucci, the governor’s former law partner and a Republican strategist, told The Auditor that national Republican leaders “tried to see if there was some interest, and there wasn’t any.” He added that Christie,who served as New Jersey U.S. Attorney from 2002 to 2008, wants to focus on New Jersey. “The governor is in the midst of his legislative agenda,” Palatucci told the newspaper. “There’s no reason to try to get involved in federal issues.”
Rep. Paul Ryan of Wisconsin will be delivering the Republican response.
The liberal Salon.com called Christie’s decision a political calculation. Salon wrote:
Giving the response to the State of the Union seems like a big honor, and “rising stars” are often chosen to do it, but it’s actually not a very good gig: There’s no real upside, and lots of potential pitfalls. The response is always either forgotten, or remembered for the wrong reasons. Plus Christie only likes yelling at people on camera when they’re in the same room as him — shouting “you’re the worst thing in the entire world ever, show me some respect” or whatever at an absent president would not be a good look.
In addition, Christie turned down an invitation to attend the annual conference of the Conservative Political Action Committee, known as CPAC, in March.
New Jersey Gov. Chris Christie (R) and his wife Mary Pat Christie arrive at the White House for last week's state dinner honoring Chinese president Hu Jintao. (Getty)
Christie spokesman Michael Drewniak told the newspaper, “I can only tell you that the governor receives hundreds of speaking and appearance invitations every month, many of which are declined for a number of reasons,” adding, “As with our other declinations, I don’t see the need to explain it to The Star-Ledger.”
However, attending last week’s White House state dinner honoring President Hu Jintao of China did garner some national press for Christie.
The newspaper reported that before the jazz concert that followed the dinner, Christie and his wife, Mary Pat Christie, found major Democratic supporters Barbra Streisand and James Brolin sitting in their seats. White House staffers had to move the two celebrities.
An insider told the newspaper, “Now I know the world has really changed, when they’re moving Barbra Streisand and James Brolin out of seats that are reserved for Christie.”
The Justice Department’s antitrust chief addressed concerns Monday about the effect of last year’s health care law on competition among medical providers.
Assistant Attorney General Christine Varney said her office is keeping an eye on accountable care organizations, which are groups made up of physicians and hospitals that share the duty of caring for patients. The organizations were authorized by the health care law to cut costs, but providers want guarantees from the government they won’t run afoul of antitrust laws in forming them.
Speaking at the left-leaning Center for American Progress think tank, Varney said that her division is working with federal agencies that handle Medicare and Medicaid matters to make sure that accountable care organizations will give consumers first-rate, cost-effective health care. The organizations are slated to begin operation in January 2012.
“The success of health care reform will depend as much upon healthy competitive markets as it will on regulatory change,” Varney said. “If health care reform is to harness the power of competitive markets to produce more efficient systems and higher quality health care delivery, then we must guard against undue concentration or anti-competitive conduct in these markets with responsible enforcement and effective advocacy.”
Varney said her division will give providers “clear and practicable guidance” on how to establish accountable care organizations that are compliant with antitrust laws. But details on accountable care organizations are still hazy.
The Centers for Medicare and Medicaid Services, the federal agency that runs the programs, hasn’t released complete rules for accountable care organizations yet. What is known, however, is that the health care law says accountable care organizations would stand to receive extra money for reducing costs for Medicare patients.
Medicare traditionally has rewarded health care providers for more services and spending. The accountable care organizations provision of the health care law is part of an effort to reduce the spending for Medicare, which cost $509 billion in 2009 and is expected to rise in the coming years. Accountable care organizations could save about $4.9 billion through 2019, according to the Congressional Budget Office.
Some in the medical community fear that accountable care organizations could control certain markets through hospital mergers and doctor acquisitions, hurting competition. Varney said her division will closely monitor developments with accountable care organizations and the continued evolution of the health care system.
“As our health care system evolves, the Antitrust Division will be there every step of the way,” Varney said.
A video of her remarks and a panel discussion at the Center for American Progress on accountable care organizations is below.
a
a
a
________________________________________________________________________
FOR IMMEDIATE RELEASE
TUESDAY, JANUARY 25, 2011
WWW.JUSTICE.GOV
REMARKS AS PREPARED FOR DELIVERY BY ASSOCIATE ATTORNEY GENERAL TOM PERRELLI
AT THE DEFENDING CHILDHOOD GRANTEE MEETING
WASHINGTON, D.C.
Good morning. I know it’s early in our first day, but I hope you are already getting a sense of just how important Defending Childhood is to the Department of Justice. One of my responsibilities here at the Department that I find most rewarding is overseeing all of the Department’s grant programs. This allows me the opportunity to support the excellent work related to children, youth and violence that comes out of the Office of Justice Programs, the Office on Violence Against Women and the Office of Community Oriented Policing Services. A hallmark of this Department of Justice’s approach to its work is collaboration – if we want to work with communities on broad-ranging and truly comprehensive solutions to problems, we ourselves in the Department need to work together. The Defending Childhood Initiative is one of several in the Department where we have sought to enhance how we work together, all with the goal of better helping our partners in cities, towns, reservations, and rural areas throughout the Nation.
We are here today because communities across the country face a reality that is simply unacceptable – our children are exposed to far more violence than I think most people realize and that is intolerable. We can have only one response – something must be done. I want to echo what the leaders from all our components have said about the vital importance of this initiative. It has the potential to substantially change the lives of American children and families. With the Attorney General’s Defending Childhood Initiative, the Justice Department is committing to a comprehensive approach to a pervasive problem. With a fragmented approach, children exposed to violence can slip through the cracks of every service system. Other times, these children may be viewed as collateral damage in shattered lives – or, most tragically, when the sources of their trauma goes unnoticed, as troublemakers or delinquents. This initiative is about targeting and breaking the cycle of violence that affects our most vulnerable Americans.
This initiative seeks to redefine how the Justice Department responds to children who experience violence, witness violence, or suffer ongoing negative ramifications from violence. We have devised an initiative that will harness resources from across the Department to – first, prevent exposure to violence when possible; second to mitigate the negative impact of violence when it does occur; and third, to develop knowledge and spread awareness that will ultimately improve our homes, cities, towns, and communities. We are integrating efforts to protect and assist children exposed to violence into everything we do at the Justice Department.
Tomorrow you’ll hear from the Attorney General firsthand. This is a very personal undertaking for him. He has been a leader and a visionary in this area. As he will tell you, he first focused on this issue more than a decade ago and it was his efforts, as Deputy Attorney General, that led to much of the Department’s work on these issues and was a catalyst for much of the research and experience we will discuss over the next couple of days. He has made it clear that the Defending Childhood Initiative is a top priority for the Department and he has promoted the importance of this initiative throughout the Administration. In his proclamation declaring October as National Domestic Violence Awareness Month, President Obama mentioned Defending Childhood as part of our efforts to help children who are the victims and witnesses of domestic violence. He noted that children who experience violence face many obstacles and that prevention and early intervention efforts can do much to help them.
I will also note that this is a very personal undertaking for me. As a parent, one naturally wants to protect children, but I was stunned by the results of the National Survey on Children Exposed to Violence. I have also been deeply affected by what we have learned over the years in areas such as truancy – where the correlations with a host of other problems that are likely to cause truancy and a host of negative outcomes that may follow are extraordinary – and bullying, which so often is a product of a young person who themselves was victim or witness of violence. It was an honor when the Attorney General asked me to help construct the Initiative, and I am a constant and strong advocate for funding of the Initiative. I also want to note that the Initiative is evidence of the Department’s renewed commitment to its trust responsibility to Tribal Nations; that is why two of the pilot sites are tribal communities.
As I noted, we do not work on a blank slate; much work has been done on the problem of children exposed to violence – both to understand the problem and to develop promising practices to address it. Most recently, our efforts to generate knowledge included the National Survey of Children’s Exposure to Violence. The Attorney General will cover the detailed statistics tomorrow. I’ll just highlight a few facts and point out that this study really helps bring the importance of our work into focus.
We have now been able to document the extent to which the same kids are often victimized again and again. A child who is exposed to one type of violence is more likely to be exposed to other types of violence, or to be exposed multiple times. More than 38 percent of children reported more than one direct victimization within the previous year. The study also found that a child who was physically assaulted in the past year would be five times as likely to also have been sexually victimized and more than four times as likely to also have been maltreated during that period. Children who should be getting treatment and being protected are instead being subjected to victimization once again.
We also learned, sadly, that children are more likely to be exposed to violence and crime than adults. For instance, a 2005 study showed that juveniles and young adults ages 12 to 19 were more than twice as likely to be the victims of violent crimes as the population as a whole. And we know that children who are exposed to violence are more likely to abuse drugs and alcohol, suffer from depression and anxiety, have problems in school, experience or perpetuate dating violence, and engage in criminal behavior later in life.
Through the Defending Childhood initiative, the Department of Justice is focused on implementing concrete knowledge to combat children’s exposure to violence. For years, we’ve worked to develop our knowledge about this issue and to promote promising approaches. Defending Childhood takes this a step further by calling for direct action in targeted communities – your communities. The best way that we can break this vicious cycle of violence is by working to prevent children’s exposure to violence, to provide appropriate interventions when we can’t prevent exposure, and to increase knowledge and raise awareness about this issue. These are the goals of Defending Childhood.
As I noted at the outset, we believe collaboration is key. Today, I’m joined by a wide variety of DOJ representatives and you’ll hear from even more in the next few days. This effort cuts across the entire Department, not just OJP, OVW and COPS. Representatives from the FBI as well as the U.S. Attorneys Offices across the country are important partners in Defending Childhood.
We’re also building partnerships with other federal agencies including the Department of Health and Human Services and the Department of Education. We worked with HHS in the late 1990s on the Safe From the Start Action Plan, and they continue to play a key role in helping children exposed to violence. You’ll hear from HHS representatives tomorrow, and we’re thrilled that we’ve already been able to work with them to jointly develop information about evidence-based practices that will be presented during one of tomorrow’s workshops. Going forward, there will be many additional opportunities for collaboration with these and other federal agencies. At the federal level, this is truly an unprecedented effort to comprehensively address children’s exposure to violence.
But there are many critical partners outside the federal government. We plan to do outreach to law enforcement organizations. We’re working to inform and support law enforcement officers as first responders. Officers have the unique opportunity to help with the early identification of children exposed to violence, and we want to encourage their involvement.
We are tapping the knowledge of national experts and continuing to advance science in this area. One of our first steps in launching this initiative was to host a meeting of a small group of national experts on this topic. Then, this past summer, several DOJ representatives attended the International Family Violence and Child Victimization Research Conference and met with the experts assembled there. We plan to continue to hold small group meetings and to use them to identify pressing issues and innovative approaches.
But by far our most important partners are all of you – you who daily face the problems of violence in your communities and its devastating impact on children. We have asked for unprecedented collaboration from you and among all those who serve young people across your communities, from law enforcement to social services, to the courts, and beyond. Your knowledge, your experience, your commitment, and your hard work are the most essential ingredient in this effort, which is too important to fail. Not only will your work, we hope, make for demonstrably better lives for children in your communities and improve the quality of life for the entire community, but we also hope that, through scientific evaluation integrated into your demonstration sites from the beginning, we will expand our knowledge on children’s exposure to violence, develop best practices, and help communities across the country facing similar challenges. .
I understand that you have ambitious agenda of topics to cover over the next two and a half days, and I hope you will find the time to be productive. I truly appreciate your time and commend your dedication to these issues. I look forward to continued opportunities to work with you as we move forward to help Defending Childhood achieve its goals. I also look forward to hearing from you now about your communities and your plans and hope to visit some, if not all, of your communities in the coming year.
###
Attorney General Eric Holder issued a memo to Justice Department employees Friday ordering a hiring freeze, citing the overall federal budget crunch. He also asked the FBI, Bureau of Alcohol, Tobacco, Firearms and Explosives, Drug Enforcement Administration and U.S. Marshals to curb non-personnel spending, ABC News reported.
In the memo, Holder said the freeze is necessary because the government is funded through March 4 by a temporary continuing resolution, which keeps current funding at the same levels from the 2010 fiscal year. By freezing hiring, Holder said he hoped to minimize “more severe future measures, such as staff furloughs.”
Other cutbacks include eliminating non-essential travel and not attending conferences. DOJ’s counterterrorism work and anti-drug operations will continue as is, Justice Department officials told ABC News.
“Given the Department’s vast size and broad responsibilities, the financial restrictions that I announced will be difficult but, given our funding restraints, are required,” Holder wrote. He added: “I anticipate revisiting the Department’s hiring and and staffing situation in the spring, once we know our likely full-year funding level.”
.
President Barack Obama announced Monday that he will nominate Donald B. Verrilli Jr. to be Solicitor General.
Currently a deputy counsel to the president, Verrilli participated in more than 100 cases before the Supreme Court while a lawyer in private practice, arguing 12 of them. The Solicitor General argues the U.S. position in litigation before the Supreme Court.
Then-Associate Deputy Attorney General Donald Verrilli at a panel at American University in 2009 (Photo by Main Justice).
The president passed over acting Solicitor General Neal Katyal, who was rumored to be a favorite of Attorney General Eric Holder’s for the job.
Katyal, while a Georgetown University Law Center professor in 2006, argued the landmark Hamdan v. Rumsfeld case before the Supreme Court, in which the military tribunals at Guantanamo Bay set up by the George W. Bush administration were declared to violate the Uniform Code of Military Justice and the Geneva Conventions. The Hamdan case made Katyal a darling of left-leaning progressives. But in the increasingly polarized Senate, that record made it unlikely that Republicans would confirm him.
The post has been filled on an acting basis since Elena Kagan was confirmed on March 19, 2009 to sit on the Supreme Court.
Verrilli was a litigator for more than 20 years in the Washington, D.C., office of the law firm Jenner & Block, where he served alongside Associate Attorney General Tom Perrelli, the department’s No. 3 official. Verrilli focused on First Amendment, telecommunications, and intellectual property law. He co-chaired the firm’s Supreme Court practice group from 2000 until 2009.
In February 2009, Verrilli joined the Justice Department as an Associate Deputy Attorney General with oversight over domestic and national security policy, before moving on to the White House.
He served as a law clerk to the Supreme Court Justice William J. Brennan, Jr. and to J. Skelly Wright of the United States Court of Appeals for the D.C. Circuit. Verrilli received his J.D. from Columbia Law School, where he was Editor-in-Chief of the Columbia Law Review. He received his undergraduate degree from Yale University.
Associate Attorney General Perrelli speaks with Secretary Sebelius (DOJ)
The federal government recovered some $4 billion in fiscal 2010 from people who tried to defraud Medicare and Medicaid, Department of Health and Human Services Secretary Kathleen Sebelius and Associate Attorney General Tom Perrelli announced Monday.
In releasing the results of an annual report, the officials cited the Justice Department and HHS led-Health Care Fraud Prevention & Enforcement Action Team (HEAT) in May 2009 and the accomplishments of the teams located throughout seven cities that enforced Medicare fraud recovery efforts. In the fiscal year that ended Sept. 30, 2010, the teams imprisoned 146 defendants and indicted 140 individuals involving charges filed against 284 defendants who collectively billed Medicare more than $590 million.
DOJ opened more than 2,000 criminal and civil health care fraud investigations, the highest number initiated in a single year, according to Perrelli.
An example of those recoveries was the Astra Zeneca case. In April 2010, Astra Zeneca LP and its subsidiary paid $520 million to resolve false claims act allegations that they illegally marketed the anti-psychotic drug Seroquell for uses not approved as safe and effective by the FDA.
DOJ alleged that between 2001 and 2006, Astra Zeneca promoted Seroquell to psychiatrists and doctors for certain uses not approved as safe and effective including Alzheimer’s disease, Attention Deficit Hyperactivity Disorder, depression and other conditions.
From day one, President Barack Obama has made it clear that particularly in these difficult financial times, eliminating fraud, waste and abuse can’t be the job of one agency or department; it needs to be the focus of every single one of us in government, Sebelius said.
HHS also announced new rules authorized by the Affordable Care Act that will aim to proactively prevent and fight fraud, waste and abuse in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP).
The new rules will create a screening process for providers and suppliers in Medicare, Medicaid and CHIP to keep fraudulent providers out of the programs; require a new enrollment process that will mandate states to screen Medicaid and CHIP providers; the power to temporarily stop enrollment of potentially high-risk, new providers and suppliers; and the power to temporarily stop payments to providers and suppliers in cases of suspected fraud.
Perrelli and Sebelius were joined by the Centers for Medicare and Medicaid Services Administrator Donald Berwick, Assistant Director of the FBI’s Criminal Investigative Division Kevin Perkins, Deputy HHS Inspector General Gerald Roy and Executive Director of the Coalition Against Insurance Fraud Dennis Jay.
a
a
a
a
__________________________________________________________________________
FOR IMMEDIATE RELEASE
MONDAY, JANUARY 24, 2011
WWW.JUSTICE.GOV
HHS
HEALTH CARE FRAUD PREVENTION AND ENFORCEMENT EFFORTS RECOVER RECORD $4 BILLION; NEW AFFORDABLE CARE ACT TOOLS WILL HELP FIGHT FRAUD
Joint Justice Department & HHS Efforts Result in Largest Sum Ever Recovered in Single Year
WASHINGTON – Associate Attorney General Tom Perrelli and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today released a new report showing that the government’s health care fraud prevention and enforcement efforts recovered more than $4 billion in taxpayer dollars in Fiscal Year (FY) 2010. This is the highest annual amount ever recovered from people who attempted to defraud seniors and taxpayers, or from those who sought payments to which they were not entitled. In addition, HHS today announced new rules authorized by the Affordable Care Act that will help the department prevent and fight fraud, waste and abuse in Medicare, Medicaid and the Children’s Health Insurance Program (CHIP).
These findings, released today, in the annual Health Care Fraud and Abuse Control Program (HCFAC) report, are a result of President Obama making the elimination of fraud, waste and abuse a top priority in his administration. The success of this joint Department of Justice and HHS effort would not have been possible without the Health Care Fraud Prevention & Enforcement Action Team (HEAT), created in 2009 to prevent waste, fraud and abuse in the Medicare and Medicaid programs, and to crack down on the fraud perpetrators who are abusing the system and costing American taxpayers billions of dollars. These efforts to reduce fraud will continue to improve with the new tools and resources provided by the Affordable Care Act, including the new rules announced today.
“Our aggressive pursuit of health care fraud has resulted in the largest recovery of taxpayer dollars in the history of the Justice Department,” said Associate Attorney General Perrelli. “These actions are in large part because of the great work being led by the Health Care Fraud Prevention and Enforcement Action Team. Through this initiative, we are working in partnership with government, law enforcement and industry leaders, and the public to protect taxpayer dollars, control health care costs, and ensure the strength and integrity of our most essential health care programs.”
“President Obama has made it very clear that fraud and abuse of taxpayers’ dollars are unacceptable. And for too long, our fraud prevention efforts have focused on chasing after taxpayer dollars after they have already been paid out,” said Secretary Sebelius. “Thanks to the President’s leadership and the new tools provided by the Affordable Care Act, we can focus on stopping fraud before it happens.”
HCFAC Report
More than $4 billion stolen from federal health care programs was recovered and returned to the Medicare Health Insurance Trust Fund, the Treasury and others in FY 2010. This is an unprecedented achievement for HCFAC, a joint effort of the two departments to coordinate federal, state and local law enforcement activities to fight health care fraud and abuse.
The Affordable Care Act provides additional tools and resources to help fight fraud that will help boost these efforts, including an additional $350 million for HCFAC activities. The administration is already using tools authorized by the Affordable Care Act, including enhanced screenings and enrollment requirements, increased data sharing across government, expanded overpayment recovery efforts and greater oversight of private insurance abuses.
The Departments of Justice and HHS have enhanced their coordination through HEAT and have expanded Medicare Fraud Strike Force teams since 2009. The departments hosted a series of regional fraud prevention summits around the country, and sent letters to state attorneys general urging them to work with HHS and federal, state and local law enforcement officials to mount a substantial outreach campaign to educate seniors and other Medicare beneficiaries about how to prevent scams and fraud. During FY 2010, HEAT and the Medicare Fraud Strike Force expanded local partnerships and helped educate Medicare beneficiaries about how to protect themselves against fraud.
In FY 2010, the total number of cities with strike force prosecution teams was increased to seven, all of which have teams of investigators and prosecutors dedicated to fighting fraud. The strike force teams use advanced data analysis techniques to identify high-billing levels in health care fraud hot spots so that interagency teams can target emerging or migrating schemes along with chronic fraud by criminals masquerading as health care providers or suppliers. Strike force enforcement accomplishments in all seven cities during FY 2010 include:
* 140 indictments involving charges filed against 284 defendants who collectively billed the Medicare program more than $590 million;
* 217 guilty pleas negotiated and 19 jury trials litigated, winning guilty verdicts against 23 defendants; and
* 146 defendants were sentenced to prison during the fiscal year, averaging more than 40 months of incarceration.
Including strike force matters, federal prosecutors opened 1,116 criminal health care fraud investigations as of the end of FY 2010, and filed criminal charges in 488 cases involving 931 defendants. A total of 726 defendants were convicted for health care fraud-related crimes during the year.
In addition to these criminal enforcement successes, 2010 was a record year for recoveries obtained in civil health care matters brought under the False Claims Act—more than $2.5 billion, which is the largest in the history of the Department of Justice.
The HCFAC annual report can be found here, oig.hhs.gov/publications/hcfac.asp. For more information on the joint DOJ-HHS Strike Force activities, visit: www.StopMedicareFraud.gov/.
New Affordable Care Act Rules to Fight Fraud
Today, HHS also announced new rules authorized by the Affordable Care Act which will help stop health care fraud. The provisions of the Affordable Care Act implemented through this final rule include new provider screening and enforcement measures to help keep bad actors out of Medicare, Medicaid and CHIP. The final rule also contains important authority to suspend payments when a credible allegation of fraud is being investigated.
“Thanks to the new law, CMS now has additional resources to help detect fraud and stop criminals from getting into the system in the first place,” said Centers for Medicare and Medicaid Services (CMS) Administrator Donald Berwick, M.D. “The Affordable Care Act’s new authorities allow us to develop sophisticated, new systems of monitoring and oversight to not only help us crack down on fraudulent activity scamming these programs, but also help us to prevent the loss of taxpayer dollars across the board for millions of American health care consumers.”
A copy of the regulation is on display today at the Federal Register and may be downloaded from the following link: www.ofr.gov/inspection.aspx. Several days after the regulation is published, the preceding link will be deactivated and the published version of the regulation will be available on the National Archives website at www.archives.gov/federal-register/news.html. CMS will continue to take public comments on limited areas of this final rule for 60 days.
More information can be found at www.HealthCare.gov, a web portal made available by the U.S. Department of Health and Human Services. A fact sheet on the new rules is available at www.HealthCare.gov/news/factsheets.
###
a
a
a
a
______________________________________________________________________________
FOR IMMEDIATE RELEASE ASG
MONDAY, JANUARY 24, 2011
WWW.JUSTICE.GOV
REMARKS AS PREPARED FOR DELIVERY BY ASSOCIATE ATTORNEY GENERAL TOM PERRELLI AT THE DEPARTMENT OF JUSTICE – HEALTH AND HUMAN SERVICES HEALTH CARE FRAUD PRESS CONFERENCE
WASHINGTON, D.C.
Thank you Secretary Sebelius. Good morning. I’m pleased to join Secretary Sebelius, CMS Administrator Don Berwick and Dennis Jay of the Coalition Against Insurance Fraud in providing an update on our joint efforts to combat health care fraud and, specifically, to protect taxpayer dollars and our Medicare and Medicaid programs.
My name is Tom Perrelli, and I’m the Associate Attorney General of the Department of Justice. In that capacity, I oversee the federal government’s civil litigation across the country, including the Justice Department’s efforts to recover billions of taxpayer dollars lost to fraud, waste and abuse, including health care fraud. Fighting health care fraud has been one of this Administration’s and the Justice Department’s top law enforcement priorities. And it’s not just because we want to stop the wrongdoers from ripping off American taxpayers, senior citizens, and patients. It’s also because we know that few decisions are more critical to the quality of our lives, our children’s lives, and our parents’ lives, than the decisions we make about health care. When consumers are treated by health care professionals, they should have treatment that is not tainted by kickbacks, not influenced by misleading marketing schemes, and not made more expensive by a fraudster’s desire to put profits over patients.
The Departments of Justice and HHS have a long history of working together in this fight against health care fraud. While we know that most health care dollars are spent on healing sick Americans and most companies and providers work hard to play by the rules, we also know that too much money is lost to fraud and abuse. So, we have been fighting back together, on behalf of American taxpayers and patients.
Today’s “Health Care Fraud and Abuse Control Program Report” outlines our prevention and enforcement achievements in that fight during this Fiscal Year 2010. This latest HCFAC report tells the story – loud and clear – that President Obama’s goal and our two agencies’ unparalleled commitment to prevent, identify, and prosecute the most egregious instances of health care fraud is making a stunning difference:
* In just the last fiscal year, a record $4.0 billion in taxpayer dollars was recovered for the Medicare Trust Fund, other Federal Agencies, and whistleblowers who helped ferret out fraud. A total of approximately $2.86 billion was deposited to the Medicare Trust Fund – an increase of more than $350 million over the prior year’s total.
* We won or negotiated approximately $2.5 billion in health care fraud judgments and settlements – that’s the largest annual figure in history and a leap of more than 50% in just one year – from Fiscal Year 2009.
* We at DOJ also opened more than 2,000 criminal and civil health care fraud investigations – that’s more than 1,100 new criminal health care fraud investigations and almost 950 new civil health care fraud investigations. All three are the highest numbers ever for health care fraud investigations initiated in a single year.
* Our prosecutors in the Justice Department’s Criminal Division and our U.S. Attorney’s Offices have been incredibly hard at work as well. We reached an all-time high in the number of health care fraud defendants charged – more than 930 health care fraud defendants. That’s a 16% increase over the prior fiscal year. In Fiscal Year 2010, we secured more than 700 criminal convictions for health care fraud.
These numbers tell us that the HEAT partnership that Secretary Sebelius highlighted has been incredibly effective. It was May 2009, when Attorney General Holder and Secretary Sebelius brought our two agencies together to create the Health Care Fraud Prevention & Enforcement Action Team – which we call HEAT. HEAT elevated DOJ’s and HHS’ joint commitment to combating health care fraud to a Cabinet-level priority – aggressively bringing to bear the full resources of the federal government against those who would illegally divert taxpayer resources for their own gain.
Over the past two years, this unprecedented collaboration made possible by HEAT has led to extraordinary results. In the last two years, we at the Department of Justice have recovered a record amount of taxpayer dollars lost to health care fraud than in any other two-year period in the Department’s history. Those recoveries include cases like the AstraZeneca case. Last April, AstraZeneca LP and its subsidiary paid $520 million to resolve False Claims Act allegations that they illegally marketed the anti-psychotic drug Seroquel for uses not approved as safe and effective by the FDA. Such unapproved uses are known as “off-label” uses because they are not included in the drug’s FDA approved product label. We alleged that between 2001 through 2006, AstraZeneca promoted Seroquel to psychiatrists and doctors for certain uses not approved as safe and effective, including for Alzheimer’s disease, attention deficit hyperactivity disorder, depression, and other conditions. In addition to off-label marketing, the civil settlement resolved claims that AstraZeneca violated the federal Anti-Kickback Statute by offering and paying illegal monies to doctors it recruited to promote unapproved uses of Seroquel, to induce doctors to prescribe the drug for unapproved uses.
On the criminal side, the DOJ and HHS Medicare Fraud Strike Forces have been a big part of our success story. During the past fiscal year, we expanded these strike forces to three new regions – to include Brooklyn, New York; Baton Rouge, Louisiana; and Tampa, Florida. These are areas in the country where the Medicare data is showing “hot spots” of unexplained high billing levels. The Report details some of the Strike Forces’ accomplishments over the past fiscal year, including:
* 140 criminal indictments involving charges filed against nearly 300 defendants who collectively billed the Medicare program more than half a billion dollars;
* More than 200 guilty pleas negotiated and 19 jury trials litigated, with winning guilty verdicts against 23 defendants; and
* 146 defendants sentenced to prison during the fiscal year, averaging more than 40 months of incarceration.
We are proud of all this great work being done by the Justice Department’s prosecutors, FBI agents, analysts and investigators, working hand-in-hand with our partners at HHS. These accomplishments reflect this Administration’s ongoing and intensive efforts to protect the American people and to safeguard precious taxpayer dollars in these times of tight budgets. Our commitment to protecting American patient safety, combating fraud, and returning much-needed dollars back to the U.S. Treasury and state treasuries is just one of the ways we’re working hard to help the American people. And investing in anti-fraud measures pays off huge dividends. All told, since the HCFAC Program started in 1997, DOJ and HHS have returned over $18.0 billion to the Medicare Trust Fund. The return on investment for the HCFAC program, since 1997, is nearly $5 returned for every $1 expended. Since 2008, the return on investment for the HCFAC program is $6.8 dollars for every $1 expended; in short, HCFAC is today an even better investment for the American taxpayer.
Despite all that’s been accomplished, we know that we can’t rest – more work needs to be done. Secretary Sebelius explained that the landmark Affordable Care Act provides tougher measures to prevent fraud in the first place, as well as new resources. The health care law also provides tougher rules and penalties, to help the Justice Department in stopping and preventing health care fraud as well.
The successes outlined in today’s report and the new tools in the health care law motivate us to do even better in the months and years ahead. The Department of Justice will continue to work vigorously with our partners at HHS, the private sector and in the non-profit world to ensure that all patients are not cheated when it comes to their health care and that those who commit fraud will be caught and punished.
Thank you everyone and a special thank you to Secretary Sebelius and her team at HHS for being such committed partners of the Attorney General’s and all of us at DOJ. I’d like to turn it over now to CMS Administrator Dr. Donald Berwick.
###
Although Michael Moore, the new U.S. Attorney for the Middle District of Georgia, knows that much of his job is administrative, he doesn’t plan on staying out of the courtroom, the Macon Telegraph reported.
Moore was sworn in Oct. 6, 2010, after his September 2009 nomination languished in the Senate for about a year before he was confirmed.
Michael Moore (Andrew Ramonas/Main Justice)
Main Justice reported on possible reasons for the delay on the Senate vote, including his peripheral involvement in a fraud cause and a delay in paperwork being returned to the Senate Judiciary Committee.
Since taking over the office four months ago, Moore has met with staff members in the U.S. Attorney’s office and at the U.S. District Court, the newspaper reported. He also has established goals for the office, including an increased emphasis on prosecuting cases that could result in forfeitures, child sex cases, health care fraud, public corruption and gun and drug cases.
Moore also told the newspaper that he’s “committed to making an immediate local impact,” and is reaching out to rural law enforcement and prosecutors to let them know of their allies in the U.S. Attorney’s office.
As for being out of the courtroom since taking over his new post, Moore said, “I’m going through a little bit of withdrawal.” He added that he hopes to try some cases and stay “plugged in,” the Macon Telegraph reported.
