Justice Department zeros in on EHR fraud after record number of false claims: 5 details

The Justice Department opened a record number of healthcare fraud cases in 2020 and is focusing its fraud initiatives on healthcare employees who make false claims with EHRs, according to a June 29 Bloomberg Law report.

Five details:

  1. Michael Granston, deputy assistant attorney general for the Justice Department's commercial litigation branch, said at a June 29 American Health Law Association annual meeting that the department "opened over 900 new matters, including 580 new health fraud matters.

  2. The department settled 366 false claims cases and 265 of the cases were healthcare-related.

  3. In addition to false EHR-related claims, the Justice Department is honing in on those who deceptively request COVID-19 relief funds, contribute to the opioid crisis, manipulate Medicare's managed care program and abuse older adults.

  4. Fraud has been a downside of the digitalization of healthcare. The HHS Office of Inspector General estimates that telehealth fraud cost taxpayers $4.5 billion last year, according to a June 30 Politico report.

  5. The risk of fraud has also played a role in the conversation surrounding the permanent expansion of telehealth. Government Accountability Office health officials told the Senate Finance Committee in May that virtual care could invite fraud and drive up healthcare spending, Politico reported.

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