A LOOK BACK.... A LOOK AHEAD -

Perhaps the single most appropriate word to describe the current state of the civil and criminal healthcare fraud enforcement environment is uncertainty. From changes in personnel and policy at the highest levels of government to a myriad of state and federal legislative developments, healthcare providers face an unsettled landscape as they move into the coming year.

To be sure, statistics would suggest that it was business as usual for the government’s healthcare fraud enforcement efforts. While civil fraud recoveries by the U.S. Department of Justice (DOJ) dipped to more than $2.88 billion in the fiscal year ending September 30, 2018 (FY 2018) as compared to $3.7 billion in FY 2017, recoveries attributable to the healthcare industry were $2.5 billion in FY 2018 — up from $2.1 billion in FY 2017. This is the ninth consecutive year where recoveries associated with the healthcare industry exceeded $2 billion.