In 2016, the Department of Justice (DOJ) recouped $4.7 billion.
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The DOJ’s collection stems from False Claims Act settlements and judgments. Of this money, the majority was from the healthcare industry.
Almost half of the $2.5 billion healthcare settlements were from pharmaceutical and medical device companies.
What actions on the part of healthcare workers resulted in these settlements and judgments?
The False Claims Act covers a myriad of bad acts, but some include illegal kickbacks and charging federal programs more than commercial customers, due to bundling payments.
The DOJ has indicated that the collections help all those insured by federal health care programs, including veterans, the elderly and low-income families.
702 of the 845 False Claims Actions were qui tam actions brought by whistleblowers. The rest were initiated by the government.
How can you avoid facing a qui tam action or government audit?
Make sure that your practice’s compliance program and your risk assessment are up to date.
Last year, the DOJ issued a memorandum on Individual Accountability for Corporate Wrongdoing. It explained that the Department intends to increase investigations into individuals.
Make sure your employees are trained on consequences for violations of applicable federal and state laws.
We help our clients keep their compliance programs up to date and their employees trained on all relevant regulations.
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P.S. If you or your patients are interested in consumer healthcare issues, check out myhealthspin.com.