Bass, Berry & Sims attorneys Matt Curley and Brian Roark provided an overview of trends related to hospital fraud and abuse enforcement in a recent article published by Becker's Hospital Review. The article, titled "7 Notable Developments in Hospital Fraud & Abuse Enforcement," discusses the following trends in hospital enforcement:
- The government's increased willingness to bring claims alleging unnecessary care;
- The government's scrutiny of the medical need for and hospitals' billing of certain medical procedures;
- Increased awards for whistleblowers reporting Medicare fraud;
- The increased need for hospital peer-reviews in addition to internal reviews;
- The increased number of Stark and AKS cases centered around physician employment arrangements;
- The applicability of Stark to Medicaid claims; and
- The increased focus on holding individuals and entities criminally liable for healthcare fraud.
To read the article in its entirety, please click here.