WASHINGTON – Government officials have launched a Healthcare Fraud Prevention and Enforcement Action Team (HEAT) to combat Medicare fraud.

U.S. Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius announced Wednesday the creation of the interagency effort and the expansion of Strike Force team operations to Detroit and Houston.

“Every year we lose tens of billions of dollars in Medicare and Medicaid funds to fraud,” said Holder. “Those billions represent healthcare dollars that could be spent on medicine, elder care or emergency room visits, but instead are wasted on greed. This is unacceptable, and the Justice Department is committed to working with the Department of Health and Human Services to eradicate it.”

The HEAT team will include senior officials from the DOJ and HHS who will build upon and strengthen existing programs to combat fraud and invest new resources and technology to prevent fraud, waste and abuse before it happens.

“Most providers are doing the right thing and providing care with integrity,” said Sebelius. “But we cannot and will not allow billions of dollars to be stolen from Medicare and Medicaid through fraud, waste and serious abuse of the system. It’s time to bring the fight against fraud into the 21st Century and put the resources on the streets and out into the community to protect the American taxpayers and lower the cost of healthcare.”

These efforts include the expansion of joint DOJ-HHS Medicare Fraud Strike Force teams that have been fighting fraud in south Florida and Los Angeles. Established in 2007, the teams have used a “data-driven” approach to identify unexplainable billing patterns and investigating these providers for possible fraudulent activity.

The Strike Force team operating in south Florida has helped convict 146 people and secure $186 million in criminal fines and civil recoveries. After the success of operations in south Florida, the Strike Force expanded in May 2008 to Los Angeles, where 37 people have been charged with criminal healthcare fraud offenses. To date in the Los Angeles cases, more than $55 million has been ordered in restitution to the Medicare program.

“We know these strike forces work. I believe a targeted civil and criminal enforcement strategy in these locations will have a substantial impact on deterring fraud and abuse, protecting patients and the elderly from scams and ensuring that taxpayer funds are not stolen,” said Holder.

HEAT will build on demonstration projects by the HHS Inspector General and the Centers for Medicare & Medicaid Services that focus on suppliers of durable medical equipment. These projects increase site visits to potential suppliers to prevent imposters from posing as legitimate DME providers.

Fraud prevention efforts could also be strengthened if President Barack Obama’s proposed Fiscal Year 2010 budget is approved. The budget invests $311 million – a 50 percent increase from 2009 funding – to strengthen program integrity activities in the Medicare and Medicaid programs. Combined, anti-fraud efforts in the president’s budget could save $2.7 billion over five years by improving oversight and stopping fraud in the Medicare and Medicaid programs, including the Medicare Advantage and Medicare prescription drug programs.