Highlights
The DOJ’s new Corporate Whistleblower Pilot Program encourages individuals with tips regarding criminal activity in areas including private healthcare fraud to come forward in exchange for a monetary award
The program is intended to close the gaps in healthcare fraud enforcement not otherwise covered by the federal False Claims Act
In anticipation of an uptick in whistleblower activity in response to the new pilot program, providers should consider reviewing their internal reporting policies and procedures
On Aug. 1, 2024, the U.S. Department of Justice (DOJ) introduced its highly anticipated Corporate Whistleblower Pilot Program, meant to fill gaps in current federal agency whistleblower programs. One such gap relates to the healthcare industry and private insurance payers, as the False Claims Act (FCA) – the federal government’s primary civil enforcement tool for redressing fraud against the United States government – imposes liability only for fraud perpetrated against federal payers such as Medicare and Medicaid.
Under the Whistleblower Pilot Program, the DOJ aims to incentivize whistleblowers that have original information relating to federal healthcare offenses and crimes not covered by the FCA and involving private healthcare benefit programs.
Under the three-year Whistleblower Pilot Program, individuals with original, independent knowledge of corporate violations related to certain specified priority areas – including...
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...