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DOJ: cooperation in medical fraud probes will spark feds’ leniency

It’s all about reciprocity, imply officials from the U.S. Department of Justice. Play ball with us. Give our investigators timely and candid information they can use, and you will likely see some benefits coming back your way. Otherwise, well, … .

That tit-for-tat is currently being delivered by DOJ principals to executives and managers in the health care industry. Its bottom line is eminently clear.

To wit: Actively help – don’t hinder – our investigations into health care fraud, and derive some upside from cooperating. And be motivated to proactively assist in any regulatory fraud probe of your enterprise. Recalcitrance will be well remembered when authorities assess penalties applicable to your behavior.

Prosecuting medical fraud is obviously a key goal for government law enforcers these days. The number of federal False Claims cases being litigated has exponentially increased in recent years, now numbering in the many hundreds annually. Industry enterprises and care providers targeted in fraud probes reportedly forked out a stunning $2.5 billion in fines and judgment costs last year.

DOJ leaders are now spreading the word on new fraud-linked guidance policies they say will bring broadly reciprocal benefits. Early and notable company cooperation into probe matters (marked especially by voluntary disclosures) will help to streamline government investigations, saving time and resources. And it will be duly noted when the DOJ’s civil division focuses on penalties and damage demands linked with fraudulent conduct.

One insider commentator notes that the guidance “is part of a growing trend of the Justice Department reaching out to resolve cases faster.”

Given the spiking numbers of FCA fraud cases targeting health care actors and the resulting challenges in managing them, the new strategy makes fundamental sense.

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