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On January 31, 2011, the federal government announced the Health Care Fraud and Abuse Control Program (HCFAC) recovered more than $4 billion. The program’s 2010 return on investment (ROI) was $4.9 for each $1 spent on enforcement. For the 2008-2010 period, the HCFAC ROI has averaged $6.8 in recoveries for each dollar spent on investigation and enforcement. The Department of Health and Human Services (HHS) and Office of the Inspector General (OIG) audit disallowances accounted for about $687 million. The Centers for Medicare and Medicaid Services (CMS) restitution and compensatory damages accounted for $336 million. These . . .

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Managed Care Financing & Service Delivery Systems