The Department of Justice obtained more than $3 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending Sept. 30, 2019. Of the more than $3 billion in settlements and judgments recovered by the Department of Justice this past fiscal year, $2.6 billion relates to matters that involved the health care industry, including drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories, and physicians. Home health providers also continued to be one of the biggest offenders. This is the tenth consecutive year that the department’s civil health care fraud settlements and judgments have exceeded $2 billion. The amounts included in the $2.6 billion reflect only federal losses, but in many of these cases the department was instrumental in recovering additional millions of dollars for state Medicaid programs.
Some of the biggest violations outlined in the DOJ’s press release involved kickbacks and marketing offenses in addition to the usual outright fraudelent billing that we’ve come to expect from bad actors. All providers need to take every step possible to ensure that they are not unintentionally violating any recent kickback legislation such as EKRA.