The Rise of Coordinated Health Care Fraud Enforcement

Law360, New York (September 23, 2014, 10:21 AM EDT) -- Health care fraud is a top enforcement priority among federal and state agencies. A well-coordinated group of federal agencies within the U.S. Department of Health and Human Services and the U.S. Department of Justice have ratcheted up the intensity in administrative, civil and criminal investigations and prosecutions. This recent federal coordination reflects a model employed by state attorneys general through their respective Medicaid fraud control units and the National Association of Medicaid Fraud Control Units. Consequently, there has been a dramatic rise in successful large-scale health care fraud investigations and prosecutions involving billions of dollars in false or fraudulent claims. Medicare and Medicaid providers must be proactive and vigilant in their compliance with applicable federal and state law. Otherwise, they risk severe penalties and potentially long terms of imprisonment....

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