Yates memo, whistleblowers poised to influence fraud enforcement

Experts say individual accountability outlined in the Yates memo, along with the potential for more whistleblower claims, will drive healthcare fraud enforcement in the coming years, according to the Dallas Business Journal.

The news outlet hosted an event in which a panel of fraud experts pointed to the government's growing focus on fraud detection and individual accountability within fraud schemes. Following a memo from the Justice Department's Deputy Attorney General Sally Q. Yates in September, federal prosecutors have targeted individual executives who may have been complicit in fraud schemes.

Patrick Souter, a healthcare attorney with Gray Reed & McGraw, said the DOJ is going beyond just looking at employees and investigating those with a less direct connection to the organization.

"We have seen increased scrutiny of the professionals who advise those folks as well, whether it's a consultant, attorney, accountant--anybody who is being paid from that organization--they can be considered an agent of that entity," he said.

Lisa-Beth Meletta, the Assistant U.S. Attorney at the DOJ, said the government is still keeping a close eye on hospice, home health and medical directorships, adding that companies must have a system in place to address compliance concerns from employees before they turn to the government.

"Nine times out of 10, a whistleblower has complained to the company and gotten nowhere," she said.

To learn more:
- read the Dallas Business Journal article

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