AHA - American Hospital Association

07/02/2025 | News release | Distributed by Public on 07/02/2025 15:44

DOJ, HHS announce working group to investigate health care fraud

The Departments of Justice and Health and Human Services today announced the creation of the DOJ-HHS False Claims Act Working Group to combat health care fraud. The group will be jointly led by the HHS General Counsel and the Deputy Assistant Attorney General of the DOJ's Commercial Litigation Branch and include participants from the Office of Counsel to the HHS Office of Inspector General, DOJ's Civil Division, the Centers for Medicare & Medicaid Services' Center for Program Integrity and designees representing U.S. Attorneys' Offices.

The working group's priority areas for enforcement include Medicare Advantage; drug, device or biologics pricing; barriers to patient access to care; kickbacks related to drugs, medical devices, durable medical equipment, and other products paid for by federal health care programs; materially defective medical devices impacting patient safety; and manipulation of electronic health records systems to drive inappropriate usage of Medicare-covered products and services. The working group is encouraging whistleblowers to identify and report violations of the FCA related to those priority enforcement areas.

Fraud
Medicare Advantage
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