Consumer information

 

Feds tighten up

 

Tougher health fraud penalties. Stopping widespread Medicare and Medicaid fraud is a special focus of federal efforts. Congress has enacted tougher penalties and expanded current federal health insurance fraud laws to cover all payers. Medicare also has stepped up its crackdowns, especially in South Florida.

Federal agencies. The FBI, U.S. Postal Service, Medicare, Medicaid and other federal agencies are heavily involved in combating insurance fraud.
Stronger punishment. Federal law imposes stiff prison terms and fines for white-collar criminals who loot insurance companies. The law also heavily penalizes anyone who gives false financial information to state insurance regulators, and forbids convicted insurance felons from returning to the business of insurance without special permission.

Citizen lawsuits. The federal False Claims Act encourages private citizens to expose schemes by suing in civil court. Whistleblowers receive a percentage of any recoveries. Whistleblower suits are among the largest sources of recoveries in health care schemes.

Joining forces. Joint efforts among federal agencies insurers, and state and local agencies have cracked many difficult cases around the U.S. Task forces, especially, increase the pressure on large and complex fraud rings. Many task forces, for example, fight large health schemes, staged accident rings and workers compensation premium fraud.