Federal Authorities Ramping Up COVID-19 Related Health Care Fraud Prosecutions

Published: June 10, 2021

Recently announced Department of Justice (DOJ) priorities include a reinvigoration of health care fraud prosecutions. The COVID-19 crisis created fertile ground for not only fraud related to the Paycheck Protection Program (PPP) but recent announcements make crystal clear that enforcement of health care fraud arising from COVID-19 related schemes also has a high priority.

With billions in government funds at stake, only the human imagination limited potential fraud possibilities. The DOJ has formed the COVID-19 Interagency Working Group as part of the Health Care Fraud Unit. Individual executives and business entities were targeted for criminal prosecution for violations relating to telehealth billings, COVID-19 testing, improper test bundling, and overbilling, among other COVID-19 related schemes. Like PPP fraud allegations, many of the health care fraud allegations relate to attempts to take advantage of limited government oversight given the massive sums of money and relative speed of the new funding.

While the prosecution of civil and criminal health care fraud violations is not new, the COVID-19 crisis exponentially increased the fraud exposure. Health care providers and contractors should pay particular attention to COVID-19 related billings and procedures to ensure compliance. Self-audits and compliance checks are just two actions that can be taken to minimize the risks of liability.

Examples of some precautionary steps which could prevent fraud include:

In the event your business has concerns about COVID-19 related activities, Steptoe & Johnson has an experienced Health Care Team and former federal prosecutors who can assist with navigating federal investigations.

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