Health Care Fraud Prevention and Enforcement Action Team (HEAT) was created in 2009 to reduce fraud, waste and abuse in the Medicare and Medicaid programs and to crack down on individuals and organizations that are bleeding the system. Last year, the Justice Department opened 1,131 new criminal fraud investigations involving as many as 2,148 defendants. Convictions have been achieved on 826 defendants in fraud-related crimes during the year. In the same year, the department opened 885 new civil investigations.
In 2012, CMS began screening all 1.5 million Medicare-enrolled providers through
the new Automated Provider Screening system. APS fingers ineligible and potentially fraudulent providers and suppliers prior to
enrollment or revalidation. Nearly
150,000 ineligible providers have been eliminated from
Medicare’s billing system so far.
CarePrecise's standard database of healthcare providers includes a field that indicates providers who may still be active, but have been added to the federal List of Excluded Individuals and Entities, tying excluded providers to their NPI numbers.
