Compliance | False Claims Act

$2.6 Billion Collected By Feds From Compliance Cheats. ROI Makes Warren Buffet Look Like An Amateur.

Even Warren Buffet can’t get you this return: 420% over three years.

And, it’s 100% leveraged. OPM.

Well, not OPM as in “other people’s money,” but OPM as in “our public money.”

That’s the return on investment that the Feds generated from 2015 to 2017 as a result of coordinated Department of Health and Human Services and Department of Justice healthcare anti-fraud operations.

In total, their efforts returned $2.6 billion.

And, as icing on the compliance cake, the Feds also obtained some non-monetary rewards (especially for those who count convictions as wins): In 2017 alone, the DOJ opened 967 new criminal healthcare fraud investigations, leading to criminal charges against 720 defendants. 639 defendants were convicted of health care fraud-related crimes during the year.

But that’s just the DOJ. The joint DHHS/DOJ Medicare Fraud Strike Force brought charges against an additional 478 defendants, negotiated 290 guilty pleas and obtained convictions against another 40 defendants. 305 individuals went off to prison for an average sentence of more than 50 months behind bars.

If you previously wondered why we have laws such as the federal Anti-Kickback Statute and Stark, and questioned whether they are based on fact or fiction, you might as well give up your queries. After all, it’s a big business. No, that’s incorrect. It’s a big bureaucracy.

In the vernacular, them’s the facts. So, we have to deal with them.

Compliance is not just a punch card list. It’s not just a plan. It’s not just a program. It’s a target, the one that’s painted on your back. There’s hotlines and whistleblowers and strike forces and postal inspectors and Assistant U.S. Attorneys looking to make their stripes. You have to assume that they’re all looking at you.

There’s baseline self-inspections, there are red teams to privately ferret out your weaknesses, there’s active compliance versus passive time wasting. If you need help, get in touch fast.

Get moving. Now.

Comment or contact me if you’d like to discuss this post.

Mark F. Weiss

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