Bill seeks to close healthcare program exclusion loophole in fraud cases

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A bill introduced in the House would expand HHS' Office of Inspector General's ability to exclude individuals from participating in federal healthcare programs, according to a Bloomberg report.

Reps. Lois Frankel (D-Fla.) and William Keating (D-Mass.) introduced the Fighting Medicare Fraud Act of 2016 on Tuesday. The bill would let the OIG exclude individuals from healthcare programs if they are affiliated with an organization that has been penalized for fraud.

For instance, if an individual was an executive at a health system that was engaged in fraudulent activity, but stepped down from the position before the organization was penalized, that person would be eligible for exclusion under the bill.

More and more, the government is holding individuals — not just the organizations they work for — responsible for fraud. In a memo issued in September, the U.S. Department of Justice showed it is taking a strong stance on pursuing healthcare executives involved in fraud allegations.

The memo — which has been dubbed the "Yates memo" after Deputy Attorney General Sally Yates — was distributed to federal prosecutors. It provides guidance on steps the DOJ is taking to strengthen its pursuit of individual corporate wrongdoing. One key change is that to be eligible for any cooperation credit, companies must provide the names of individuals involved in the fraud, no matter where they sit within the company.

More articles on healthcare fraud:

Anesthesiologist gets 8 years for fraud that led to patient death
Fraud, theft and a teen's fixation with playing physician
Healthcare CEO faces life in prison for fraud that led to 2 patient deaths

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