On January 26th, the Senate Judiciary Committee addressed fraud
enforcement in their first hearing of the new Congressional
session. In this most recent hearing, the Judiciary Committee
placed special emphasis on health care fraud. The federal
government estimates between $45 billion to $75 billion is paid to
health care "fraudsters" each year. In fiscal year 2009,
the federal government recovered $2.5 billion from health care
fraud cases. Lawmakers want to close that recovery gap with more
civil recoveries, criminal investigations, prosecutions, and
convictions.
Lawmakers are concerned that medical professionals have become
accustomed to paying their way out of these claims as part of the
cost of doing business. As a result, they want the Justice
Department to increase prosecutions of not only the businesses and
organizations that violate federal laws but also go after the
individuals within the organizations. In these economic times, the
recovery of fraudulently paid funds and the income through fines
and penalties are an attractive political subject. But the
Judiciary Committee voiced more than its desire to increase fines,
the Committee emphasized the need to increase prison sentences for
violating heath care anti-fraud laws. Lawmakers see jail time as a
powerful deterrent to health care fraud. Many courts can be more
lenient in sentencing health care fraud crimes over violent crimes
and the Committee wants to see that health care
"fraudsters" are put behind bars.
The subject of the first Judiciary Committee hearing of the 112th
Congress signals that a crackdown on federal fraud is a top
priority for the lawmakers. The current leadership of the Senate
Judiciary Committee (Sen. Patrick Leahy, D-VT and Sen. Chuck
Grassley, R-IA) have been very active in strengthening federal
fraud laws. Sen. Leahy and Sen. Grassley authored numerous
anti-fraud acts, including the 1986 amendments to the federal False
Claims Act and the recent Fraud Enforcement and Recovery Act. This
hearing early in the 112th Congress indicates that the lawmakers
may be sharpening their pencils to strengthen fraud enforcement
further in new legislation. Proposals may include increasing fines,
increasing jail time, requiring more frequent progress reports on
health care fraud prosecutions from the Department of Justice, and
increasing funding for fraud prosecutions. One way or another,
federal oversight of health care fraud will only be strengthened in
the coming years. As a result, health care providers are encouraged
to review and update their compliance programs or risk stiffer
fines in the future or even jail time.
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