Enacted by Congress in 1863, the False Claims Act is intended to protect the federal government against those who defraud it. For health care practitioners, this is applied to transactions with Medicaid and other federal health programs. Complying with FCA can protect you from being labeled a “fraudster” for unintentional billing errors.
Civil penalties for violation of the FCA range between $5,500 per claim up to triple the amount of the government’s losses.
If you file a lot of claims with Medicaid or other federal health plans and are not doing it by the book, the penalties can add up quickly. Being found guilty of an FCA violation can result in prosecution with fines and prison time and your exclusion from federally funded health plans.
Feds Turning up the HEAT
With the establishment of the Health Care Fraud Prevention & Enforcement Action Team (HEAT) in 2009, state and federal government fraud investigations are at an all time high. In 2014 alone, the U.S. Department of Justice recovered $3.3 billion from companies and individuals who attempted to defraud federal health programs such as Medicaid and Medicare.
Protect Your Practice and Career
Don’t go on hoping that you and your staff are doing it right and are in compliance. Our expert training, assessment and consulting services ensure that you quickly achieve full compliance. We’re here to help. If you have any questions at all, don’t hesitate to reach out.