Through healthcare fraud cases and settlements in 2016, Department of Health and Human Services (HHS) and Department of Justice (DoJ) initiatives returned over $3.3 billion to the federal government and individuals, including $1.7 billion to Medicare Trust Funds, the Office of the Inspector General (OIG) recently reported. The 2016 healthcare fraud judgements and settlements also resulted in $235.2 million of federal Medicaid money being returned to the government.

Compared to 2015 results, the Healthcare Fraud and Abuse Control Program recouped $900 million more in 2016 from healthcare fraud investigations and settlements.

OIG noted that collaborative efforts by the federal departments through the Healthcare Fraud and Abuse Control Program helped to return more improper claims reimbursements and healthcare payments. The program has returned about $31 billion to the Medicare Trust Funds since 1997.

Over the past seven years, though, the program, though, has seen more funds being returned from healthcare fraud schemes. Since 2009, the program returned over $17.9 billion to the federal government and individuals.

The Health Care Fraud Prevention and Enforcement Action Team (HEAT) program launched in 2009 and has transitioned through several data sharing and healthcare prevention program improvements in the last year. “DoJ and HHS have expanded data sharing and improved information sharing procedures in order to get critical data and information into the hands of law enforcement to track patterns of fraud and abuse and increase efficiency in investigating and prosecuting complex healthcare fraud cases,” wrote the OIG. “This expanded data sharing enables the DoJ and HHS to efficiently identify and target the worst actors in the system.”

DoJ opened 975 new healthcare fraud investigations in 2016 and opened 930 new civil healthcare fraud investigations. These investigations resulted in the filing of criminal charges in 480 cases comprised of 802 defendants.

Last year, OIG investigations led to 800 criminal actions against Medicaid and Medicare fraud perpetrators and 667 civil actions. Resulting from Medicaid and Medicare fraud investigations, some providers and other healthcare entities were no longer included in federal healthcare programs. In 2016, OIG excluded 3,635 individuals and entities from participating in Medicaid, Medicare, and other federal healthcare programs.