Trends in Health Care Fraud Enforcement
In June, the Departments of Justice (DOJ) and Health and Human Services charged 601 individuals in the largest health care fraud enforcement action to date. The enforcement actions (dubbed the “National Health Care Fraud Takedown”) were led by the Health Care Fraud Unit and the Medicare Fraud Strike Force, and charged individuals in 58 federal districts for their alleged participation in billions of dollars in false billings as well as for their roles in prescribing and distributing opioids and other dangerous narcotics.
Join Callan Stein and Miranda Hooker, Pepper Hamilton partners and members of the firm’s White Collar Litigation and Investigations Practice Group and Health Sciences Department, for a discussion of these charges and some of the trends they reveal in government enforcement actions targeting facilities and individual health care providers for their roles in alleged health care fraud, as well as strategies that can be employed to avoid government prosecution.
Among the trends that are discussed include:
- Increased scrutiny of the “medical necessity” of medications and procedures billed to federal health programs
- Federal prosecutors’ use of the Travel Act to expand the scope of conduct and claims it can prosecute
- Government enforcement actions targeting opioid diversion and prescribing patterns
- Increased government scrutiny of provider practices involving patient quotas, procedure time limits, etc.
This webinar is approved for 1.0 substantive CLE credits in Pennsylvania. Attorneys licensed in New Jersey may claim credit for this program under New Jersey's reciprocity policy.
This webinar is sponsored by Pepper Hamilton's Health Sciences Department, a team of 110 attorneys who collaborate across disciplines to solve complex legal challenges confronting clients throughout the health sciences spectrum.