Fraud Healthcare Dept. of Justice

Fraud is the making of false representations or engaging in deceptive behavior in order to unlawfully secure financial or personal gain. 
News & Analysis as of

The Intractable Problem of Medicare Fraud

You have to admire the vigilance and dedication of prosecutors and law enforcement investigators who fight Medicare fraud. There is no question that they have ramped up enforcement and promoted a strong message of deterrence....more

Record Numbers for Medicare Fraud Task Force Prosecutions in 2013

On January 27, 2014, the U.S. Department of Justice issued a press release announcing that its Medicare Fraud Task Force had “set record numbers for health care prosecutions in Fiscal Year 2013.” ...more

False Claim Act: 2013 Year in Review

Last year continued the trend of robust False Claims Act (FCA) enforcement by the U.S. Department of Justice (DOJ) and proliferating qui tam lawsuits brought by whistleblowers on behalf of the United States. In 2012, DOJ...more

Former ArthroCare CEO and CFO Charged with Securities Fraud, Wire Fraud

On July 16, 2013, the U.S. Department of Justice (DOJ) indicted Michael Baker and Michael Gluk, the former CEO and CFO, respectively, of ArthroCare Corp. – a Texas-based publicly traded surgical device company. Baker and...more

Protecting Your Hospital From Over-Utilization Prosecutions

The government has been increasing its focus on healthcare fraud involving “quality” of care. This is an extremely difficult issue, especially for prosecutors. It is very difficult to define “quality” standards and then...more

The Healthcare Industry And The Voluntary Disclosure Process

It is always important to consider how different parts of the government handle voluntary disclosures. The FCPA enforcement initiative has been largely the result of the voluntary disclosure process, and the government...more

Immigration Alert: January 2013

In this issue: - H-1B Nonimmigrant Season Opens on April 1, 2013, for Fiscal Year 2014 - Report Finds Immigration Laws Frustrate the Admission of Critical Health Care Professionals - Senators Offer...more

What To Do If The Feds Come Knocking At Your Door!

Your employee handbook likely addresses, in great detail, the do's and don'ts of using the internet while at the office, guidance on HIPAA, and even the company's policy on sexual harassment, but does it provide any...more

Record Healthcare Fraud Recovery Calls for Compliance

To date in 2012, the Department of Justice secured a record $3.3 billion in settlements and judgments in civil cases alleging healthcare fraud against the government under the Federal False Claims Act (“FCA”). The figure,...more

Plugging The Leak: Tackling The Problem Of Healthcare Fraud

The Justice Department and the Department of Health and Human Services have made healthcare fraud a number one priority – it is another example of the synergy of politics and enforcement. Congress spends more money on...more

Who is Committing Healthcare Fraud?

The financial recoveries for healthcare fraud are staggering. The Justice Department and Health and Human Services (Office of Inspector General (“OIG”) and Centers for Medicare and Medicaid Services (“CMS”)) regularly...more

Targeting Healthcare Fraud by Data Mining

The Department of Justice continues to trumpet its healthcare fraud program. Just last week, the Justice Department and HHS announced another nationwide sweep resulting in the arrest of 91 individuals....more

GlaxoSmithKline Settlement Puts Healthcare Industry on Notice

With the Justice Department’s announcement that GlaxoSmithKline will pay $3 billion in the largest healthcare fraud settlement in U.S. history, all drug companies – and any other businesses working in healthcare or...more

Healthcare Fraud = Vigourous Prosecution

The Department of Justice (DOJ) is making the prosecution of healthcare fraud a priority. This is straight from the mouth of DOJ's chief of the Health Care Fraud Unit, whose name is Hank Walther. In a recent interview,...more

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