July 5, 2011 | Comments Off on Government Stepping Up Criminal Enforcement Efforts
Posted by Frank Ciesla
At the American Health Lawyers Association (AHLA) conference in Boston last week, the presenters, particularly those from the Justice Department or Centers for Medicare & Medicaid Services (CMS), consistently made the following position clear: there will be more criminal enforcement activity in the healthcare arena.
The government believes that civil monetary penalties, recoupment, and debarment have proven inadequate to prevent fraud and abuse in the Medicare or Medicaid programs. Therefore, the government has now elected to more vigorously utilize the criminal provisions of the various healthcare enforcement statutes (including the numerous changes in the Patient Protection and Affordable Care Act (PPACA)) to attempt to discourage fraudulent activity on behalf of providers. This, of course, ups the ante as to the government’s challenge to healthcare providers and requires more diligence on the part of healthcare providers to avoid confronting the new criminal law enforcement mindset of the federal regulators.