Health Care Fraud Is Surging, and Enforcement Is Racing to Keep Up

Olshan Litigation and White Collar & Government Investigations partners Derrelle Janey and John Moon published an article in the Los Angeles Daily Journal (subscription required) entitled “Health Care Fraud Is Surging, and Enforcement Is Racing to Keep Up.” In the article, Derrelle and John discuss the rise in health care fraud enforcement in California, with a particular focus on hospice care providers, home health care operators, medical billers and compliance risk. The article explains that California has become a major focus for federal and state regulators as enforcement agencies respond to alleged fraud involving hospice billing, Medi-Cal reimbursement, unnecessary prescription drugs and kickback schemes. It also outlines why providers, billers and compliance professionals should reassess their compliance infrastructure in light of increased surveillance, audits and prosecutions. “California’s enforcement environment reflects a sustained focus on health care fraud,” Derrelle and John write. “For providers, billers and compliance professionals, the key takeaway is that robust compliance programs, meaningful oversight and ongoing monitoring are no longer best practices alone but essential risk-management tools.”