DOJ anti-fraud push could mean criminal charges for healthcare executives

A push by the U.S. Department of Justice to hold executives accountable for corporate misdeeds could mean an increased focus on prosecuting healthcare executives, the law firm Arent Fox warns.

"Although it remains to be seen whether, and to what extent, the prosecution of healthcare executives will increase, healthcare organizations and their executives should expect heightened scrutiny and should work with their counsel to take all possible steps to reduce the risk of additional exposure," the firm wrote in an alert to clients.

The alert noted that most healthcare fraud cases against large providers involved alleged violations of the federal anti-kickback statue or civil violations of the Stark law. Now, the Justice Department has signaled its intent to make corporations help them prosecute key executives before agreeing not to prosecute--or to defer prosecution--of the corporation as a whole, according to the alert.

The increased emphasis on executive prosecutions comes as the Justice Department takes aim at possible criminal activity in healthcare false claims cases. DOJ's civil division leads investigations into alleged False Claims Act violations, but the criminal division plans to more closely scrutinize alleged violations and accelerate criminal investigations conducted in parallel with the civil review. They're calling it a strike-force approach.

In a different kind of fraud case, the DOJ in February charged a former hospital chief financial officer with fraud, alleging he falsely attested that his hospital's electronic health record met meaningful use requirements.

For more information:
- read the alert
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