DOJ Pharmaceutical Prosecutions Michael Loucks First Assistant U.S. Attorney District of Massachusetts

MEDICARE/MEDICAID SPENDING TRENDS (In Billions) 1,140.2

How Much Fraud is there? 1992 GAO report estimated fraud and abuse was as high as 10% of the dollars spent on health care. If accurate, in a year in which society spends $1,000 billion on health care, $100 billion is stolen through fraud.

Resolutions > $10,000,000 (110) Years Total Recoveries Criminal Fines % 1991-1995 856,600,000 125,300,000 14.6 1996-2000 3,602,040,776 349,000,000 9.7 2001-Aug 2006 9,362,622,955 1,254,091,556 13.4 Totals 13,821,263,731 1,477,792,815 10.6

Drug Industry Cases Years Total Recoveries Pharma Cases % 1991-1995 856,600,000 171,000,000 19.9 1996-2000 3,602,040,776 274,440,776 7.6 2001-Present 9,362,622,955 5,388,666,004 57.6 Totals 13,821,263,731 5,834,106,780 42.2

The 110 Resolutions: sectors Ambulance: 2 Carriers: 7 Dialysis: 5 DME: 2 Home Health: 5 Hospital: 29 Laboratory: 10 Medical Device: 10 Pharmaceutical: 28 Program Eligibility: 3 Rehabilitative Medicine Services: 1

The 110 Resolutions: by size $500,000,000+: 7 $250,000,000-$500,000,000: 12 $100,000,000-$250,000,000: 14 $50,000,000-$99,999,999: 17 $20,000,000-$49,999,999: 29 $10,000,000-$19,999,999: 31