Hype: Fraud and Abuse Enforcement Will Have A Major Impact on Health Care Costs

Health care fraud and abuse enforcement will yield major program savings only if there is a cultural change among errant health care providers which leads them to believe that they shouldn't steal health care dollars.

Why should we believe that federal fraud and abuse investigation and prosecution will yield major savings under health care reform? My experience as a health care attorney was that federal attorneys would focus on a case only if there was an opportunity to recover a large sum relatively quickly for the government. They were not interested in spending their energy and government resources unless there was a significant return on the dollars invested in investigation and prosecution. Until federal attorneys' promotions, recommendations and career evaluations include consideration of their success in changing the culture which fosters fraudulent activities, rather than just how much money they rake in for the government, they will have no major incentive to attack the low level operators who do not seem to pose much of a threat to our society, but in total, bleed enormous sums from our health care system.