Bass, Berry & Sims is pleased to announce the release of the 10th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2021. Compiled by the firm’s Healthcare Fraud & Abuse Task Force, the Review provides a comprehensive analysis of enforcement developments affecting the healthcare industry, significant court decisions involving the False Claims Act, and an overview of settlements involving fraud and abuse issues.

We began the Review a decade ago with the intention of providing comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers each year. During that time, we have endeavored to cover key enforcement initiatives, analyze important case developments, document healthcare fraud settlements across the industry, and present those topics in a readily digestible format for our readers.

As recently reported by the Department of Justice (DOJ), the federal government recovered $5.6 billion from FCA cases in FY2021, which ended September 30, 2021. This represents the second largest announced recovery total in the history of the False Claims Act and the largest recovery since DOJ pulled in $6.2 billion in FY2014. As most often is the case, the healthcare industry accounted for the overwhelming percentage of the recoveries at $5 billion of the total recoveries in FY2021, or nearly 90 percent. Over the last 10 years, the federal government has recovered more than $25 billion in civil fraud settlements and judgments involving the healthcare industry. We continue to pay close attention to the fraud and abuse issues related to these recoveries and other enforcement matters impacting the healthcare industry.

Our Review covers these issues and looks ahead to the challenges healthcare providers will face stemming from increased government scrutiny concerning CARES Act and COVID-19-related relief, whistleblower lawsuits under the False Claims Act, and government regulators pursuing civil and criminal healthcare fraud enforcement.

This year’s Review examines:

• Issues for the healthcare industry to watch

• Noteworthy healthcare fraud and abuse settlements

• Comprehensive coverage of significant False Claims Act decisions

• Notable developments involving the Stark Law and Anti-Kickback Statute

• Enforcement developments impacting the pharmaceutical and medical device industries