Health Care Enforcement Defense Alert: Fraud and Abuse Enforcement: Big Recoveries in 2009; Big Plans for 2010

Health care fraud and abuse enforcement and prevention were a top government priority in fiscal year (FY) 2009, and enforcement activity will only increase in FY 2010 and beyond, affecting providers of all types. On May 13, 2010, the Department of Health and Human Services (HHS) and Department of Justice (DOJ) released the Health Care Fraud and Abuse Control (HCFAC) Program Annual Report for FY 20091 (HCFAC Report). The HCFAC Report details the $2.51 billion the government recovered through health care fraud and abuse enforcement activities, and describes the breadth of the government’s enforcement initiatives, resources, and accomplishments.

A press release issued by HHS that same day highlights the new enforcement tools authorized by the Patient Protection and Affordable Care Act2 (Affordable Care Act) and makes clear that enforcement activity will increase in FY 2010.3 In the release, HHS Inspector General Daniel R. Levinson states: “[c]riminals have concluded that health care fraud is a safe bet. It is imperative that we change the calculus. With the expanded resources and enforcement tools provided in the Affordable Care Act, OIG and its partners will be bringing the fight to the criminals to prevent, detect, and swiftly punish those who steal from taxpayers and abuse the public trust.”

Please see full alert below for more information.

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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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