Companies should take notice of several pronouncements made by Department of Justice (DOJ) officials earlier this week at the Health Care Compliance Association's (HCCA) annual Healthcare Enforcement Compliance Conference in Washington, D.C.
First, John “Fritz” Scanlon, assistant chief of the DOJ's criminal division, fraud section, announced plans to add more health care prosecutors to its ranks in the coming months. Presently, DOJ has about 75 prosecutors dedicated to investigating health care fraud. While he did not specify the exact number of new prosecutors to be hired, Mr. Scanlon suggested the increased head count will be “substantial.” This message echoes earlier statements by DOJ officials that its investigation and enforcement activities are stepping up, and this confirms additional resources will be dedicated to those efforts.
Mr. Scanlon's comments also highlighted several recent cases, including related to paying kickbacks for patient referrals, and a telemarketing scheme targeting Medicare beneficiaries. He also emphasized the importance of voluntary disclosure of violations and full cooperation to avoid criminal prosecution – a theme DOJ has been reinforcing in recent months.
Second, Thomas Tynan, acting assistant chief of DOJ's health care fraud unit, focused his comments on DOJ's priorities for health care fraud investigations. These include Medicare Advantage, COVID-19 testing scams, pandemic-related fraud, and schemes that target particularly vulnerable patients, such as patients in hospice or undergoing treatment for opioids.