Are You Ready for DOJ Enforcement?

Last year, the Department of Justice (DOJ) recouped $2.2 billion in False Claims Act (FCA) settlements and judgments.

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The DOJ stressed that the FCA is one of the most important tools for ensuring public funds are spent properly.

Over 77% of recovered funds were healthcare funds.

What types of claims resulted in settlements and actions?

  • COVID-19 fraud – these were related to improper use of government funds related to the pandemic
  • Unnecessary services – this includes providers who billed for services that were not medically necessary
  • Standard of care – this includes nursing homes that failed to meet the appropriate standards of care
  • Kickbacks – these were related to improper referrals and remuneration
  • Medicaid – this included improper drug designations, services billed that were not allowed medical expenses.

What does this mean for your practice?

Know that the False Claims Act is still a hot button for the DOJ and act proactively.

You need to make sure that your compliance plan is up to date, compliance actions are properly reported, employees are routinely trained, and any compliance concerns are mitigated.

We help our clients put effective compliance plans in place to protect their healthcare entities from whistleblowers, fines and penalties.

If you do have a compliance issue arise, call us immediately to help respond and investigate.

If you have questions or need help with your healthcare practice, employee training, or security, contact Rickard & Associates today.

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