In this assignment you will have an opportunity to review an annual report produced by the Department of Justice. The report summarizes compliance activities conducted by Federal agencies and the outcomes of cases which have been prosecuted.
In this assignment you will have an opportunity to review an annual report produced by the Department of Justice. The report summarizes compliance activities conducted by Federal agencies and the outcomes of cases which have been prosecuted.
Download the Heathcare fraud and abuse
and complete the questions using information found within the Annual Report attached (below.
The department of justice healthcare fraud and abuse control program annual report for 2015
and worksheet Heathcare fraud and abuse
The Department of Health and Human Services
And
The Department of Justice
Health Care Fraud and Abuse Control Program
Annual Report for Fiscal Year 2015
FEBRUARY 2016
TABLE OF CONTENTS
I. Executive Summary 1
II. Statutory Background 3
III. Program Results and Accomplishments 5
Monetary Results 5
Expenditures 7
Overall Recoveries 8
Health Care Fraud Prevention and Enforcement Action Team 8
Health Care Fraud Prevention Partnership 9
Medicare Fraud Strike Force 10
Highlights of Successful Criminal and Civil Investigations 12
IV. Department of Health and Human Services 36
Office of Inspector General 36
Centers for Medicare & Medicaid Services 45
Administration on Community Living 56
Office of the General Counsel 58
Food and Drug Administration Pharmaceutical Fraud Program 62
V. Department of Justice 64
United States Attorneys 64
Civil Division 66
Criminal Division 69
Civil Rights Division 72
VI. Appendix 77
Federal Bureau of Investigation 77
Return on Investment Calculation 80
Total HCFAC Resources 81
VII. Glossary of Terms 82
GENERAL NOTE
All years are fiscal years unless otherwise
noted in the text.
EXECUTIVE SUMMARY
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established a national
Health Care Fraud and Abuse Control Program (HCFAC or the Program) under the joint
direction of the Attorney General and the Secretary of the Department of Health and Human
Services (HHS)1
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