Civil cases involving fraud against the government continue to be lucrative for the federal government. For the second year in a row, the federal Department of Justice recovered over $3 billion relying on the federal False Claims Act (and its treble damages provision). In fiscal year 2011, $2.4 billion of the $3 billion recovery came from alleged fraud against federal health care programs, such as Medicare and Medicaid that were paid by health care providers and suppliers. Anticipate continued aggressive enforcement against providers in 2012, and take the time now to review your compliance with health care laws and regulations.

How can you protect yourself? A myriad of laws and regulations affect hospitals, and you can best protect your business by following these three steps. First, know what the government is interested in. Second, consider which of the government’s concerns apply to your hospital, assess how your hospital handles these concerns in practice, and develop a plan to address vulnerabilities. Third, seek appropriate counsel if you determine that your current practices may subject your hospital to governmental scrutiny.

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