After a number of slow years during the COVID-19 pandemic, the U.S. Department of Justice's Fraud Section has come back in full force by taking a record-high number of cases to trial this last year. It is important to note that this record high took place despite the fact that the number of corporate resolutions and resulting global monetary penalties hit an eight-year low.
Experts predict that federal fraud and abuse cases in the healthcare industry will increase in 2023 and 2024. The DOJ will also aggressively investigate fraud allegations related to the misuse of COVID-19 funds.
It's important to be aware that healthcare regulations were relaxed or modified during the pandemic, however, not all of those modifications were permanent. The DOJ has and will continue to investigate abuse of the relaxed regulations and not fully embracing the "old" regulations when the pandemic ended. This means that hospital systems to individual medical practices will be under scrutiny.
As the DOJ continues to take an aggressive approach to fraud and abuse cases, it's crucial for healthcare organizations to ensure they are in full compliance with all regulations. This includes implementing effective compliance programs, conducting regular training sessions for staff, and conducting regular internal audits to identify and address potential compliance issues.
In conclusion, healthcare organizations must remain vigilant as the DOJ continues to investigate and bring charges in fraud and abuse cases. By staying proactive and implementing a culture of compliance, healthcare organizations can minimize the risk of becoming a target of DOJ investigations.