The Department of Justice (DOJ) recently announced collection of over $2.5 billion dollars in judgments and settlements as a result of health care fraud cases. This is the ninth year in a row the government agency has collected over two billion dollars related to this form of fraud.
Government enforcement efforts and health care fraud: Two main claims
The DOJ specifically noted success with legal claims against these two forms of fraud:
- False claims. The first form noted by the DOJ involves cases with a false claim to an insurance company for payment. The false claim could be the result of a patient who never receives the care or service billed or because the care or service was not medically necessary.
- Anti-Kickback Statute. The release also points to success with government application of the Anti-Kickback Statute (AKS). The agency states it will continue to “place great importance on enforcing the safeguards contained within the AKS” in the future.
The statement concludes with a reminder that health care fraud enforcement efforts serve two goals: first to recoup lost funds and second to deter future wrongdoing. Although an admirable goal, it is important to note not every allegation of wrongdoing is accurate. False allegations occur and those who face these allegations must fight to protect their professional and personal reputations.
Those who find themselves in this fight are wise to seek legal counsel. An attorney experienced in Medicare fraud investigations can review your case and build a defense strategy to better ensure your legal rights are protected.