HomeCare News included commentary from Epstein Becker Green's Health Law Advisor blog post, “DOJ, HHS Announce Revamped False Claims Act Working Group,” co-authored by attorneys George B. Breen and Daniel C. Fundakowski, in the article “HHS, DOJ Form Joint Working Group to Crack Down on Fraud,” by Hannah Wolfson.
Following is an excerpt:
On the heels of revealing a huge federal fraud takedown operation, the current administration has made another move, indicating it is taking a hard line on health care fraud.
Last week, the Department of Health & Human Services (HHS) and the Department of Justice (DOJ) announced the formation of a joint False Claims Act (FCA) Working Group. Under the auspices of the working group, HHS will refer potential FCA violations to the DOJ, prioritizing Medicare Advantage, barriers to patient access to care, kickbacks for durable medical equipment, defective devices and more. …
The working group is designed to foster cross-agency collaboration for existing and new investigations, “including by leveraging HHS resources through enhanced data mining and assessment of HHS and HHS-OIG report findings,” the government said in its announcement. It will also “discuss considerations bearing on whether HHS should implement a payment suspension.”
The creation of the working group “signals that the federal government, aided by whistleblowers, will continue to rely heavily on the FCA for health care fraud and abuse enforcement, with HHS continuing to refer potential violations to DOJ,” health and compliance lawyers George Breen and Daniel Fundakowski of the firm Epstein Becker Green wrote in a web post.
“Health care and life sciences companies—particularly federal contractors—should remain vigilant about both traditional FCA risks (e.g., overbilling, billing for services that are not medically necessary, etc.) and emerging theories (e.g., civil rights violations),” they wrote. Organizations should also maintain a strong compliance infrastructure, monitor DOJ policy updates and foster a culture of transparency, they advised.
