BC Advantage - 2022 Issue 12
The U.S. Government and Cooperation Credit in Relation to the False Claims Act and the Federal Anti-Kickback Statute
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Article Overview
This article discusses how the U.S. Department of Justice and HHS-OIG approach cooperation credit in civil and criminal matters involving healthcare fraud enforcement. It is aimed at healthcare compliance professionals, attorneys, and organizations that may face government inquiries, and it highlights the role of self-disclosure, investigation response, and remediation in the broader context of False Claims Act and Anti-Kickback Statute enforcement.
Why This Topic Matters
Understanding how cooperation credit is considered can affect how healthcare organizations respond to government investigations and compliance issues. The article is relevant to entities and individuals seeking to evaluate disclosure, cooperation, and remediation strategies in matters involving federal healthcare fraud enforcement.
Article Sections
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Introduction
Introduces the federal agencies and enforcement framework discussed in the article, with emphasis on healthcare fraud oversight and related legal exposure.
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Analysis
Summarizes general considerations for responding to government demands, and discusses how civil and criminal cooperation credit may be evaluated by federal authorities.
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Civil
Reviews civil cooperation guidance, self-reporting considerations, and the kinds of factors that may be considered in civil enforcement matters.
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Criminal
Covers criminal enforcement policy guidance and broad considerations relevant to cooperation in corporate criminal investigations.
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Conclusion
Restates the article’s focus on compliance programs and the importance of legal counsel when responding to government inquiries.
What You Will Learn
- How federal agencies view cooperation in healthcare fraud matters
- What general issues arise when entities respond to civil or criminal government investigations
- Why self-disclosure and remediation are important topics in enforcement policy
- How civil and criminal enforcement considerations differ in broad terms
- Why counsel and compliance planning matter in government investigations
Who Should Read This
- Healthcare compliance professionals
- Healthcare organizations
- Attorneys
- Corporate legal departments
- Risk management teams
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