Fiscal year 2023 saw record recoveries and the highest number of settlements and judgments ever under the Federal False Claims Act. According to a new report released by the United States Department of Justice (“DOJ”), the federal government recovered over $2.68 billion through 543 settlements and judgments between October 1, 2022 and September 30, 2023.
The report highlights trends in the government’s enforcement priorities, including:
- Combatting fraud and abuse in Medicare Advantage which now makes up the largest component of Medicare;
- Pursuing providers for their role in contributing to and exacerbating the opioid epidemic;
- Protecting government health care programs and beneficiaries from substandard care or medically unnecessary services;
- Prosecuting pandemic-related fraud; and
- Investigating and resolving alleged kickbacks to providers in exchange for referrals.
Whistleblower or “qui tam” actions continue to make up a significant percentage of the government’s False Claims Act recoveries, with over 712 qui tam suits filed in fiscal year 2023 alone. Given the financial incentives for whistleblowers to report suspected False Claims Act violations, healthcare providers need to ensure they have appropriate processes in place to encourage employees, patients, and others to report suspected compliance issues and promptly investigate and self-report non-compliance.
How can healthcare providers reduce their risk of whistleblower actions? Check out this week’s podcast for a tip on reducing your whistleblower risk!
