What is the Cost of Falsified Claims in Healthcare?

Total healthcare spending in the US was estimated at around $3.4 trillion in 2016, and is projected to reach nearly $5.5 trillion by 2025, according to the Centers for Medicare & Medicaid Services (CMS). Given the mammoth size and rapid growth of the healthcare industry, it presents a lucrative arena for all kinds of fraud. The total cost of falsified claims is difficult to estimate, although here are some figures that offer an idea of how large it is.

In 2016, the government obtained over $4.7 billion in whistleblower civil settlements and judgements involving fraud and false claims. Of this, $2.5 billion came from the healthcare industry.

Total annual recoveries have averaged almost $4 billion since 2009. Between 2009 and 2016, a total of $31.3 billion have been recovered.

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