4.5 Article

Combating Fraud In Health Care: An Essential Component Of Any Cost Containment Strategy

Journal

HEALTH AFFAIRS
Volume 28, Issue 5, Pages 1351-1356

Publisher

PROJECT HOPE
DOI: 10.1377/hlthaff.28.5.1351

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Federal health care programs, including Medicare and Medicaid, are under attack by dishonest people who lie to the government and exploit its programs to steal taxpayers' money. The full extent of health care fraud cannot be measured precisely. However, the Federal Bureau of Investigation ( FBI) estimates that fraudulent billings to public and private health care programs are 3-10 percent of total health spending, or $75-$250 billion in fiscal year 2009. Successful efforts to stop such abuses, without unduly burdening legitimate providers, require aggressive, innovative, and sustained attention to protect taxpayers and beneficiaries. [ Health Aff (Millwood). 2009; 28(5):1351-56; 10.1377/hlthaff.28.5.1351]

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