Fraud and Abuse Regulation
In recent years, government efforts to detect and prosecute health care fraud and abuse have become aggressive. Billing errors, once viewed as mistakes, are now pursued as fraud and false claims, with the added specter of criminal charges, debarment, substantial fines and even imprisonment.
Regulations involving fraud and abuse are complex and numerous. They include self-referral prohibitions (Stark law); regulatory compliance; state and federal antikickback statutes with "safe harbors"; other federal regulations; and even less formal federal and state enforcement policy statements by regulatory authorities.
To help you limit your vulnerability to fraud and abuse problems, we analyze your joint ventures, leases, provider contracts and other transactions and relationships. Our analysis includes advice on what steps, if any, you should take to comply with applicable fraud and abuse regulations.