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FBI Recoups $2 Billion in Health Care Fraud Money

WASHINGTON--The Federal Bureau of Investigation recovered more than $2 billion in fraudulent health care monies for the fiscal year ending Sept. 30, 2006, according to its annual report, released last week.

In its "Federal Crimes Report to the Public," the FBI said the final tally included $373 million in restitutions, $1.6 billion in recoveries, $172.9 million in fines and $24.3 million in seizures. The agency said it investigated 2,423 cases of alleged health care fraud during the year, resulting in 588 indictments and 534 convictions. Many cases are awaiting plea agreements and trials, the agency said.

The most common schemes included billing for more services or equipment than was actually provided (known as "upcoding"), filing duplicate claims, kickbacks and providing unnecessary medical services. Such activities were not confined to any one sector in health care, according to the report.

"Throughout the country, various field offices have conducted their own initiatives targeting clinic, pharmacy, medical equipment, home health agency, cosmetic surgery center and other frauds," the report said.

The report also said the FBI had identified organized criminal activity in a variety of health care sectors, including durable medical equipment companies.

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