Efforts to weed out fraud now coming to fruition

July 1, 2011

False Claims Act changes included expanding the scope by eliminating the intent requirement, and expanding liability for retaining government overpayments.

The DOJ reported earlier this year that it collected more than $3 billion in civil settlements and judgments in all cases involving fraud against the government, with the vast majority of that amount coming from recoveries-$2.5 billion for fiscal year 2010. The two-year total recovery for healthcare fraud enforcement efforts is $4.6 billion.

The trend of fraud recoveries is continuing.

On top of these types of recoveries, federal enforcers are starting to target senior executives in healthcare fraud cases, with the consequences including criminal charges-even if the individual was not involved in the fraud-and banning the individual from doing business with government health programs. It is anticipated that this trend will continue through 2011, with the government probably seeing another record year for recoveries stemming from healthcare fraud enforcement.

Ultimately, it appears that the predictions made regarding the impact of FERA on healthcare fraud are coming to fruition.

This column is written for informational purposes only and should not be construed as legal advice.

Molly A. Drake is an associate at the Cleveland-based law firm Calfee, Halter & Griswold LLP.

Christopher S. Williams is a partner in the litigation practice at Calfee, Halter & Griswold LLP.