Health Care Enforcement in 2015: A Look Back on 2014 and Forecasting the Year Ahead

Mintz - Health Care Viewpoints
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In testimony before the House Oversight and Government Reform Subcommittee on Health Care in April 2011, the now-pending nominee for U.S. Attorney General, Loretta E. Lynch, stated in no uncertain terms that “fighting health care fraud is a priority of the Department of Justice.” She succinctly explained that “[w]ith the rising cost of medical care, every dollar stolen from our health care programs is one dollar too many” and that “Medicare and Medicaid fraud can also corrupt the medical decisions health care providers make with respect to their patients, placing them at risk of harm from unnecessary or unapproved treatments.” Ms. Lynch advised the subcommittee that the Department of Justice (“DOJ”) had “enhanced its efforts to protect the public fisc from health care fraud and to help ensure the integrity of patient care,” providing examples of successful efforts by the Health Care Fraud Prevention and Enforcement Action Team (“HEAT”) and Medicare Fraud Strike Force (the “Strike Force”).

In 2014, DOJ, together with the Department of Health and Human Services’ Office of Inspector General (“HHS-OIG”) and other federal and state agencies, methodically continued this approach, once again exacting steep monetary penalties and settlements from companies and imposing lengthy prison terms, fines, forfeiture, and restitution on individuals.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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