With federal agencies broadening their oversight of programs paid for by the taxpayer, you will see more scrutiny under the False Claims Act.
Any business with a connection to government financial programs, grants or federal contracts, and particularly in healthcare, should be prepared for a rise in audits, investigations and the like from whistleblowers.
Yet for the majority of firms, the problem is not a sudden court filing. It tends to be a slow build up of issues: reimbursement irregularities, some internal wrangling, billing reviews that don’t add up. Regulators are quick to act once they spot a pattern of inaccurate reporting and don’t care for what is in front of them. The ones who end up in the crosshairs are generally the organizations with onerous compliance rules or those that are churning through a lot of federal money.
Agencies must closely monitor how public money is being used. With bigger budgets and more complex reimbursement systems, there’s more room for error—and for the FCA to be applied. Technology has also changed the way investigations begin. These days, agencies can run advanced data analysis and compare billing and contract history with thousands of other organizations in a short time.
Here is what’s fueling the enforcement:
The large scale of federal spending
A rise in whistleblowers
Increasingly complex billing systems
Increased healthcare spending
Expanded oversight of contractors
Strict fraud...
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