Federal health care fraud judgments and settlements totaled $2.3 billion in fiscal year (FY) 2018 – down from $2.6 billion in recoveries in FY 2017 and $3.3 billion in FY 2016 — according to latest Health Care Fraud and Abuse Control (HCFAC) Program Annual Report. During FY 2018, the Department of Justice (DOJ) opened 1,139 new criminal health care fraud investigations, filed criminal charges in 572 cases involving 872 defendants, and launched 918 new civil health care fraud investigations. Investigative efforts by the Federal Bureau of Investigation resulted in more than 812 "operational disruptions of criminal fraud organizations," plus "the dismantlement of the criminal hierarchy of more than 207 health care fraud criminal enterprises," during this period. Furthermore, HHS Office of Inspector General (OIG) investigations resulted in 679 criminal actions and 795 civil actions related to Medicare and Medicaid, along with 2,712 exclusions of individuals and entities from federal health care programs. The HCFAC report also includes highlights of significant criminal and civil investigations, including the results of concentrated efforts to combat opioid fraud and abuse.
This article is presented for informational purposes only and is not intended to constitute legal advice.