The Justice Department and HHS have launched a joint False Claims Act Working Group to intensify efforts at combatting fraud and abuse in the federal healthcare system.
The group builds on a long-standing partnership between the agencies in enforcing the False Claims Act (FCA), a tool used to tackle healthcare fraud. Through enhanced collaboration, the DOJ-HHS Working Group aims to streamline and expedite investigations, identify new leads and leverage HHS resources, according to a July 2 news release.
The group will be co-led by senior officials from the HHS Office of General Counsel, CMS’ Center for Program Integrity, the Office of Counsel to the HHS Office of Inspector General, the Justice Department’s Civil Division, and designees from U.S. attorney’s offices. HHS general counsel, chief counsel to HHS-OIG and the deputy assistant attorney general of the Commercial Litigation Branch will all jointly lead the group.
New priorities will be added to the working group’s focus area. Among them are Medicare Advantage; device, biologics or drug pricing, along with discounts, rebates, service fees and formulary placement and price reporting arrangements; patient care access barriers like network adequacy requirement violations; kickbacks related to medical devices, durable medical equipment, drugs and other federal healthcare program-paid products; materially defective medical devices that affect patient safety; and intentional alteration of electronic health record workflows to drive unwarranted Medicare billing.
“The working group shall maximize cross-agency collaboration to expedite ongoing investigations in these priority areas and identify new leads, including by leveraging HHS resources through enhanced data mining and assessment of HHS and HHSOIG report findings,” the release said.
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