Fraud control efforts net gains for government

But some think the False Claims Act has meant that more doctors are being harassed over Medicare.

By Tanya Albert, AMNews staff. Oct. 15, 2001.

For taxpayers, the revamped federal False Claims Act has been a good investment, but its enforcement has generated accusations of harassment from doctors, a new report finds.

For every dollar the government spent fighting health care fraud using the FCA between fiscal years 1997 and 2000, it recovered $8, according to the report by Taxpayers Against Fraud, a Washington, D.C., public interest group. And those are just the tangible benefits, the study's authors said.

"You can't measure the deterrent effect," said Jack A. Meyer, PhD, co-author of the report and president of New Directions for Policy, the Washington, D.C., policy research firm that conducted the study.

"The word is getting out that you better not do this," Dr. Meyer said. "People who would have been saying, 'Lets try this,' are beginning to make corporate compliance agreements."

Congress amended the FCA in 1986, enhancing the role of whistle-blowers and increasing the amount of money the government could collect.

Health-related fraud cases accounted for 41% of the nearly $7 billion the government recovered under the FCA since its amendment, the study found. The crackdown on health fraud has resulted in health care savings. According to the report, the Medicare error rate, which measures improper payments due to estimated fraud, waste and abuse, fell to 7% in 2000. It was 14% in 1996. [...]