INSIGHT: Five Health-Care Fraud and Abuse Trends to Watch

Bloomberg BNA Health Law and Business

Anjali N.C. Downs and Carrie Valiant, Members of the Firm in the Health Care & Life Sciences practice, in the firm’s Washington, DC, office, co-authored an article in Bloomberg BNA Health Law and Business, titled “INSIGHT: Five Health-Care Fraud and Abuse Trends to Watch.”

Following is an excerpt:

The Department of Justice will continue its focus on fighting health-care fraud in 2019, but look for developments that also simplify federal regulations to avoid chilling health-care innovation. …

In 2019, we’ll see a push to simplify the regulatory environment for organizations serving the health care industry and fraud and abuse enforcement to increasingly recognize the importance of not creating a chilling effect on health-care innovation. Nevertheless, the federal government will also continue its focus on enforcement efforts, which continue to be quite lucrative for the federal government—bringing in about $2.5 billion in health-care related False Claims Act recoveries in fiscal year 2018.

Five top trends we will be watching.

  1. Stark Law, Anti-Kickback Changes
  2. Granston Memo Fallout
  3. Focus on Opioid Crisis
  4. More Criminal Sanctions/Individual Liability
  5. Managed Care Tensions