The U.S. Department of Justice (DOJ) got a new arrow in its quiver, allowing it to exponentially increase its ability to prosecute certain types of healthcare fraud.
While the False Claims Act (FCA), with its qui tam provisions empowering whistleblowers to initiate lawsuits, will remain DOJ’s primary tool to prosecute fraud perpetrated against federally funded health insurance programs like Medicare, Medicaid, Tricare, and the Indian Health Service, a new whistleblower program – the DOJ Corporate Whistleblower Awards Pilot Program – seeks to pay whistleblowers for information about federal healthcare offenses and related crimes involving fraud against private health insurers, patients, investors, and other non-governmental entities.
According to Deputy Attorney General Lisa Monaco, one of the main purposes of the Pilot Program is to close gaps left in the existing group of whistleblower reward programs, noting that while these programs (like those falling under the umbrella of the FCA) have proven indispensable, “they resemble a patchwork quilt that doesn’t cover the whole bed.” In enumerating the subject areas where DOJ is soliciting whistleblower information under the new program, DOJ identifies categories of misconduct related to healthcare: federal offenses and related crimes involving private healthcare benefit programs, fraud against patients and investors in the healthcare industry, and a catch-all provision, seeking information about other federal violations...
On Editorial Writing It is true that opinion columnists offer a personal point of view. However, this is only the start of what should be an industry standard for those professional opinion writer...