Ensuring compliance with the False Claims Act has never been more important for healthcare providers.

Bass, Berry & Sims is pleased to announce the release of the 12th annual Healthcare Fraud & Abuse Review examining important healthcare fraud developments in 2023. Compiled by the firm's Healthcare Fraud & Abuse Task Force, the Review provides a comprehensive analysis of enforcement developments affecting the healthcare industry, significant court decisions involving the False Claims Act, and an overview of settlements involving fraud and abuse issues.

We began the Review over a decade ago with the intention of providing comprehensive coverage of the most significant civil and criminal enforcement issues facing healthcare providers each year. During that time, we have endeavored to cover key enforcement initiatives, analyze important case developments, document healthcare fraud settlements across the industry, and present those topics in a readily digestible format for our readers.

As recently reported by the Department of Justice (DOJ), the federal government recovered $2.69 billion from False Claims Ace cases in FY2023, which ended September 30, 2023. As most often is the case, the healthcare industry accounted for the overwhelming percentage of the recoveries at nearly $1.82 billion of the total recoveries in FY2023 (68%). This is the 15th consecutive year that recoveries in federal civil healthcare fraud matters have exceeded $1.5 billion. We continue to pay close attention to the fraud and abuse issues related to these recoveries and other enforcement matters impacting the healthcare industry.

Our Review covers these issues and looks ahead to the challenges healthcare providers will face stemming from increased government scrutiny concerning CARES Act and COVID-19-related relief, whistleblower lawsuits under the False Claims Act, and government regulators pursuing civil and criminal healthcare fraud enforcement.

This year's Review examines:

  • Issues for the healthcare industry to watch
  • Noteworthy healthcare fraud and abuse settlements
  • Comprehensive coverage of significant False Claims Act decisions
  • Notable developments involving the Stark Law and Anti-Kickback Statute
  • Enforcement developments impacting managed care and the pharmaceutical and medical device industries

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.