Attorney General Eric Holder Speaks at the Miami Health Care Fraud Prevention Summit

Good morning. It’s a pleasure to join Secretary Sebelius in welcoming you all here, and I want to thank each of you for your participation and your partnership. Today, together, we are kicking off a series of regionally-focused conversations about how we can take our nationwide fight against health care fraud to the next level.

To combat and prevent these crimes effectively, we need your engagement. And we will rely on your unique insights. I’m encouraged by the diversity of perspectives represented here and glad to see that that top federal and state officials, administration leaders, federal, state and local law enforcement officers, health care providers, as well as area patients, physicians, business executives and caregivers are participating in today’s panels and training sessions.  

This summit is an important opportunity – the chance to build on what was discussed, and achieved, during the first "National Summit on Health Care Fraud" that Secretary Sebelius and I convened in Washington in January. We wanted to begin this new regional initiative here in Miami, which – I don’t have to tell any of you – unfortunately has become "ground zero" for health care fraud schemes.

In communities across Southern Florida, and all around the country, our health care system is under siege – exploited by criminals intent on lining their own pockets at the expense of American taxpayers, patients and private insurers.  These crimes not only drive up costs for everyone in our health care system, they hurt the long-term solvency of our essential Medicare and Medicaid programs.

But we are fighting back.

Last year brought an historic step forward in this fight. In May 2009, the Departments of Justice and Health and Human Services launched the Health Care Fraud Prevention and Enforcement Action Team, or "HEAT." Through HEAT, we’ve fostered unprecedented collaboration between our agencies and our law enforcement partners. We’ve ensured that the fight against criminal and civil health care fraud is a Cabinet-level priority. And we’ve strengthened our capacity to fight health care fraud through the enhanced use of our joint Medicare Strike Forces.

This approach is working. In fact, HEAT’s impact has been recognized by President Obama, whose FY2011 budget request includes an additional $60 million to expand our network of strike forces to additional cities. With these new resources, and our continued commitment to collaboration, I have no doubt we’ll be able to extend HEAT’s record of achievement. And this record is extraordinary.

In the last fiscal year, approximately $2.5 billion was deposited to the Medicare Trust Fund – an increase of more than half a billion dollars over the prior year’s total. We also won or negotiated more than $1.6 billion in judgments and settlements. The Justice Department’s Criminal Division and our U.S. Attorneys’ Offices opened more than 1,000 new criminal health care fraud investigations and had more than 1,600 health care fraud criminal investigations pending. We reached an "all-time high" in the number of health care fraud defendants charged, with more than 800 indictments in nearly 500 cases and close to 600 convictions. And the Justice Department’s Civil Division opened nearly 900 new civil health care fraud investigations and had more than 1,100 pending cases.

Earlier this morning, Secretary Sebelius and I announced the results of the largest federal health care fraud takedown in our nation’s history. Ninety-four people have been charged for their alleged participation in schemes to submit more than $251 million in false Medicare claims. Here in Miami, 24 defendants have been charged for their alleged involvement in fraud schemes totaling approximately $103 million. As of this morning, 36 individuals have been arrested across the country, and operations are ongoing here in Miami and in Baton Rouge, Brooklyn and Detroit. about emerging fraud schemes and help institute effective compliance and anti-fraud programs. And we will punish offenders to the fullest extent of the law.

This operation is part of a larger success story – a story that began here in Miami, where the first phase of the Strike Force was launched in March 2007. Since then, this initiative has resulted in the indictments of more than 810 individuals and organizations. More than $1.85 billion in improper Medicare claims have been identified. And a variety of large-scale fraud attempts have been stopped in their tracks.

The lesson behind these numbers – and this success – is that we can make measurable, meaningful progress in the fight against health care fraud. But we cannot do it alone. We need help from state and local leaders, and engagement from across the insurance industry and health care-provider community.

That’s what this summit is all about. Secretary Sebelius and I welcome your involvement, and we expect your recommendations to help guide and enhance HEAT’s critical work.

Despite all that’s been accomplished over the last year, we cannot yet be satisfied or become complacent. And we cannot ignore the fact that health care fraud remains a significant problem. Today, for example, an alarming number of scam artists and criminals are attempting to profit from misinformation about the Affordable Care Act. 

That’s why, last month, Secretary Sebelius and I wrote to all state attorneys general, urging them to develop outreach campaigns to educate seniors and other Medicare beneficiaries about how to protect themselves and help prevent scams. Each of you can be part of this and other public education efforts. Each of you can help to ensure that our health reform achievements are not exploited.

The good news is that the Affordable Care Act provides new resources and includes tough new rules and penalties to help stop and prevent health care fraud. We will continue to work vigorously with our law enforcement and private sector partners to ensure that those who engage in fraud cannot use this new legislation to steal from taxpayers, patients, seniors, and other vulnerable Americans. We will keep industry leaders informed

As we do our part in Washington, we want to work closely with you – and with state and local, officials, officers, leaders and advocates across the country – to fight fraud.  Our continued progress depends on the commitment we make, the priorities we establish, and the partnerships we forge now.

Your presence here today gives me great hope about what we can accomplish together. I look forward to working with you all.

And, now, I’d like to turn things over to an extraordinary leader and partner in this work – the Secretary of the Department of Health and Human Services, and my good friend, Kathleen Sebelius.