On June 30, 2016, the Department of Justice (“DOJ”) published an interim file rule that dramatically increases the per claim penalties for violations of the False Claims Act (“FCA”) and the Anti-Kickback Statute (“AKS”) among other laws.

While previously the minimum FCA penalty per claim was $5,500, it will now be $10,781 per claim. The maximum FCA penalty per claim rises from $11,000 to $21,563 per claim. Further, the penalty for violating the AKS increases from $11,000 per claim to $21,563 per claim. The DOJ has clarified that these new penalties apply only when levied as part of an assessment made after August 1, 2016, for a violation occurring after November 2, 2015.

This increase in penalties was authorized as part of the Bipartisan Budget Act of 2015. Penalties under the FCA and AKS are civil monetary penalties, which the federal government is required by law to periodically evaluate and adjust for inflation to ensure that the penalties continue to maintain their deterrent effect. The increases announced in the June 30th rule reflect the increase in the cost of living between when the law giving rise to each penalty was enacted and 2015, when the increases were authorized. These adjustments, however, were capped at 250%.

These per claim penalty increases may have a profound impact on healthcare providers as a FCA and/or AKS case against a healthcare provider may involve hundreds or thousands of claims made to the Centers for Medicare and Medicaid.

Potential Advocacy Opportunities:

• Connect with local and national professional and industry groups to understand how these groups plan to respond to the new per claim penalties
• Draft a response to DOJ’s interim final rule and submit it before August 29, 2016