Dollars Lost to Fraud

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$60 Billion Lost Annually

Medicare loses billions of dollars each year due to fraud, errors, and abuse. In 2014 testimony before the Senate Special Committee on Aging, the National Health Care Anti-Fraud Association placed these losses at approximately 60 billion annually, though the exact figure is impossible to measure. The most commonly cited range for all health care fraud estimates is 3 to 10 percent of annual health care expenditures. 2012 Medicare expenditures were nearly $600 billion and are expected to rise as the baby boomer population ages.

Fraud Convictions

The joint Department of Justice and U.S. Department of Health and Human Services (HHS) are making gains in the fight against fraud through their Medicare Fraud Strike Force.  In May 2014, HHS announced that, since its inception in March 2007, Strike Force operations in nine locations have charged almost 1,900 defendants who collectively have falsely billed the Medicare program for almost $6 billion. In addition, CMS, working in conjunction with HHS-OIG, has suspended enrollments of high-risk providers in five Strike force locations and has removed over 17,000 providers from the Medicare program since 2011 (see www.stopmedicarefraud.gov).

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