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Distilling compliance lessons from healthcare fraud cases

Jaclyn Jaeger | January 24, 2019

Healthcare-related fraud made up the bulk of False Claims Act recoveries in fiscal year 2018. Collectively, these enforcement actions offer key insight into the sort of best practices the government expects to ensure compliance with federal healthcare laws.

The False Claims Act (FCA) is the government’s primary civil remedy to redress false claims for federal funds and property involving a multitude of government operations and contracts. Although the FCA web catches a wide range of industries—including defense, financial, transportation, food, and agriculture—$2.5 billion of the $2.8 billion in total recoveries in fiscal year 2018 involved the healthcare industry, including pharmaceutical companies.

Compliance officers of healthcare and pharmaceutical companies, specifically, should be on high alert. In one of the largest FCA settlements...

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