WASHINGTON, DC—Congressman Jim Himes (CT-04) announced today that $4.3 billion in Fiscal Year 2013 and a total of $19.2 billion over the last five years in fraudulent payments in Medicare and related programs have been recovered for the benefit of U.S. taxpayers.

“It is outrageous that there are those who attempt to defraud the Medicare program, which ends up increasing premiums and other costs for the 50 million seniors and people with disabilities who rely on Medicare,” said Himes. “The Affordable Care Act provided agencies with new tools to crack down on waste, fraud, and abuse in Medicare and other federal health care programs, and the results today show these tools are working.”

This is the fifth consecutive year that the Health Care Fraud and Abuse Control Program has increased recoveries over the previous year, climbing from $2 billion in FY 2008 to over $4 billion every year since FY 2011. The report also showed that for every dollar spent on federal health care-related fraud and abuse investigations in the last three years, the government recovered $8.10.  This is the highest three-year average return on this investment in the history of the Health Care Fraud and Abuse Control Program.

These large recoveries for U.S. taxpayers are just one aspect of the comprehensive anti-fraud strategy HHS has implemented since enactment of the Affordable Care Act.  Using tools in the Affordable Care Act, HHS has also cracked down on tens of thousands of health care providers suspected of Medicare fraud.  For example, new enrollment screening techniques are proving effective in preventing high-risk health care providers from getting into the system – all of which adds to the savings for the Medicare Trust Fund.