Doctors, nurses and other health care providers in Florida may face a higher likelihood of fraud accusations or investigations in light of a new law. Federal law enforcement officials have been applying new scrutiny to health care professionals over their coding, billing and referring practices.
The Affordable Care Act allocated more federal funding to health care fraud prevention efforts. While only a small percentage of doctors break the law or act inappropriate, all medical professionals must abide by strict standards and could be investigated.
The federal False Claims Act is intended to prevent fraudulent claims being filed with government contractors. In 2010, the ACA expended the scope of this law to make it easier for federal enforcement officials to launch investigations involving health care fraud.
In 2010, when the ACA was passed, 15 percent of cases opened by the Department of Health and Human Services involved physicians. By 2012 their share had grown to 21 percent, illustrating an increased focus on health care activity and potential fraud.
A False Claims Act investigation may result in civil damages and fines, as well as criminal charges. Doctors may also face a lifetime of increased monitoring by the federal government. And even fraud allegations that turn out to be false can mean lost patients and a damaged reputation.
Next week we’ll talk more about False Claims Act violations and steps that health care providers can take to minimize their risk of being investigated. If you are the subject of a federal investigation, it is essential to act quickly to protect your rights and make sure you are represented every step of the way. Consider working with an experienced criminal defense attorney.
Source: amednews.com, “Empowered by ACA, old fraud law puts new scrutiny on doctors,” Alicia Gallegos; Feb. 25, 2013