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"Healthcare Fraud Poses Risk to Providers & Suppliers"



3/31/15: $3.3 billion dollars was returned to the US Treasury in 2014 from criminal and civil investigations by the US Department of Justice and the Department of Health and Human Services of medical device companies, pharmaceutical companies, hospitals, physicians, pharmacies, chiropractors, hospice facilities and others, according to...the report from DOJ and HHS. Since 1997, that number jumps to nearly $28 billion as a result of the Health Care Fraud and Abuse Control Program. Healthcare fraud isn’t just a risk for US-based hospitals and physicians; it’s a risk for global medical device and pharmaceutical companies that may be well-versed in global anti-corruption laws but less aware of basic healthcare fraud initiatives in the US. The Affordable Care Act has changed and intensified some of those risks and enforcement strategies. According to an article by Sean West on the FierceHealthPayer website, “Cases are investigated through real-time data analysis instead of protracted subpoena and account analyses, resulting in a shorter time between fraud identification and prosecution. There is no evidence of a slowdown in enforcement, with DOJ opening more than 900 new criminal investigations in 2014 and some nearly 800 new civil healthcare fraud cases that same year.

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