The report detailing new filings and recoveries under the False Claims Act (FCA) during the 2020 fiscal year that was just released by the U.S. Department of Justice (DOJ) suggests, at first glance, a diminished role for one of the federal government’s strongest anti-fraud tools. Delving more deeply into the details, however, demonstrates the continuing vitality of the FCA, especially when it concerns fraud against federal health insurance programs.

Indeed, given the opportunities for fraud stemming from the government programs that already have been enacted and that are likely to be enacted to combat COVID-19, and given recent statements by Washington officials promising more enforcement actions, one thing becomes abundantly clear: This year—and many years to come—undoubtedly will see a remarkably high number of whistleblower lawsuits and government-initiated actions filed under the FCA in an effort to clamp down on fraud and abuse.

Health Insurance Fraud

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