Healthcare Regulatory Enforcement Alive and Well

As written in the January/February 2017 MD News Magazine
By, Daniel K. Glessner, Attorney, Health Care Practice Group, Brouse McDowell, LPA

The 1996 Health Insurance Portability and Accountability Act ("HIPAA") established the national Healthcare Fraud and Abuse Control Program. This program requires annual reports of the government's efforts with regard to enforcement actions and the amount collected each year as a result. In 2015 that amount was $1.9 billion in healthcare fraud judgements and settlements which derived from 800 criminal actions against individuals or entities and 667 civil actions related to Medicare, Medicaid, false claims and civil monetary payments. Additionally, 4,112 individuals and entities were banned from Medicare participation. Suffice it to say that healthcare fraud and abuse enforcement has become a large revenue enhancer for the federal government. Furthermore, while final numbers will not be reported until February of this year, 2016 kept the trend of large enforcement recoveries alive and well.

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