In 2013, the U.S. Department of Justice, Health and Human Services Office of Inspector General, and other federal and state agencies continued to aggressively prosecute health care fraud and related offenses through criminal, civil, and parallel proceedings. Following the approach it has utilized to combat financial crime, the Department of Justice is entering deferred prosecution and non-prosecution agreements with corporate defendants, but prosecuting individual officers and key employees; employing electronic surveillance techniques; and, overall, using the strike force approach developed and implemented to eradicate organized crime and other gangs. This approach resulted in steep monetary penalties for companies and lengthy prison terms, as well as fines, forfeiture and restitution, for individuals. And, as in the past, the government reached civil resolutions, including multi-million dollar settlement amounts and Corporate Integrity Agreements, with a number of health care providers.
In this advisory, we consider the year’s criminal prosecutions, civil enforcement actions, and parallel proceedings, and take a look at the issues to watch out for in 2014.