George Breen Quoted in Article, "Empowered by ACA, Old Fraud Law Puts New Scrutiny on Doctors"

With the Affordable Care Act giving the government more power and dedicating more money to improving federal efforts against health care fraud, waste and abuse, physicians' business practices are under the microscope like never before.

While only a small fraction of physicians are engaged in fraudulent activity, all doctors face the new reality of increased scrutiny over billing, referral and coding activity, legal experts said. ...

Heightened federal focus on individual doctors and physician practices is likely to continue, said George B. Breen, a Washington-based attorney with Epstein Becker Green and part of the firm's health care practice. "Probably the biggest misconception [among doctors] is, 'The government is looking at the hospital and not me individually, or it's looking at another deeper pocket,' " said Breen, who also presented on the subject of FCA and compliance issues at the AHLA conference.

If the government comes knocking, physicians must be able to show how they are complying with FCA regulations and how they address problem claims, he said. "The only way you are able to defend yourself is to be proactive in engaging in activities where you are compliant." ...

While criminal health fraud enforcement has targeted hot spots such as California, Florida, New York and Texas, FCA investigations have not been as geographically focused, Breen said. "Many of the investigations nationwide are largely driven [by] the subject matter."