Analyzing Health Care False Claims Act Cases
Mintz’s Health Care Enforcement Defense practice group is proud to present EnforceMintz, a regular newsletter analyzing current events, highlighting trends, and predicting future developments related to health care fraud enforcement. Similar to our annual year in review and outlook report published in recent years, EnforceMintz will report on qui tam cases brought under the False Claims Act (FCA), other government enforcement actions, and significant regulatory developments, but we will now publish updates throughout the year.
We started off 2023 by attending the American Conference Institute’s 10th Annual Advanced Forum on False Claims and Qui Tam Enforcement, where we had the opportunity to hear about the enforcement priorities of the Department of Justice (DOJ) straight from Michael Granston, Deputy Assistant Attorney General, Civil Division. Granston highlighted DOJ’s continued interest in enforcement related to Medicare Advantage Organizations as well as alleged fraud by recipients of COVID-19 pandemic relief funds. He also assured attendees that DOJ’s cyber-fraud initiative is very active and that the agency is currently investigating a number of cyber-fraud and FCA allegations out of the public view. As you will see, all of these topics — and more — are explored in this newsletter.
Granston also provided some interesting statistics during his discussion of DOJ’s statutory authority to dismiss qui tam cases. He reported that, over the last five years, relators have filed over 3,000 FCA cases, and during that same time period, DOJ has sought to dismiss a mere 58 cases. While a closely watched case regarding the standards that govern DOJ’s exercise of its dismissal authority is currently before the Supreme Court, in practice, the statistics offered by Granston show that DOJ rarely uses its dismissal authority. That approach seems likely to persist as Granston noted that DOJ will continue to exercise its dismissal authority “sparingly and transparently.”
The next edition of EnforceMintz analyzes trends in FCA cases using data compiled by Mintz in its Qui Tam Database and DOJ’s annual report of FCA enforcement activity, which was just released earlier this week.
We also look forward to hosting a webinar entitled "Health Care Enforcement Year in Review & 2023 Outlook."
We hope you find the current issue of EnforceMintz useful and informative. We welcome your feedback and questions.
— Brian Dunphy & Karen Lovitch
Co-Chairs, Health Care Enforcement Defense Practice
// 2022 Teed Up Two False Claims Act Issues That the Supreme Court Is Poised to Answer in 2023
// With Telemedicine Here to Stay, Enforcement Agencies Continued their Scrutiny
// Medicare Advantage Remains a Top Enforcement Priority
// Despite Some Setbacks, Enforcement Authorities Continues to Focus on the Opioid Supply Chain
// 2022 Saw the Expansion of EKRA Outside of the Addiction Treatment Setting
// The Pandemic May Be Ending, But Fraud Prosecutions Will Keep Coming
// Significant 2022 Regulatory and Policy Developments
Record Settlement in a Declined Case
Continued Pursuit of EHR Technology Vendors
Slowdown in Qui Tam Cases Involving Private Equity Firms
First Settlement of a Civil Cyber-Fraud Case
Turnabout Is Fair Play