Forbes magazine has dubbed 2014 “The Year of the Whistleblower.” For healthcare providers, this designation has translated into millions of dollars in fines and penalties and the initiation of criminal investigations.
Just last month, the Health Care Fraud Prevention and Enforcement Action Team (HEAT), settled a whistleblower-initiated lawsuit filed against a healthcare provider for $350 million to resolve claims that it violated the False Claims Act by paying physicians kickbacks to induce the referral of patients to its dialysis clinics. The provider also agreed to forfeit $39 million based on conduct related to two transactions of its joint venture.
Healthcare providers are under growing scrutiny as government regulators become more aggressive in their pursuit of healthcare fraud. Headlines spouting promises of increased criminal prosecutions of individuals, commitments to protect taxpayer dollars and changes to the laws making it easier for whistleblowers to bring healthcare fraud claims have become the norm.
The regulators’ enforcement tool of choice? The federal False Claims Act.