Outpatient Facility Coding Alert - 2019 Issue 18
Fraud & Abuse: Enforcement Reaches New Heights in September Takedowns
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Article Overview
This article summarizes a series of September healthcare fraud and abuse enforcement actions involving federal agencies and prosecutors. It is useful for compliance, revenue integrity, legal, and auditing audiences who track enforcement trends, False Claims Act activity, and criminal healthcare cases across multiple states and specialties. The piece covers the general scope of the takedowns, the agencies involved, and the broad categories of alleged misconduct without serving as a coding reference or procedural guide.
Why This Topic Matters
It helps readers understand current enforcement priorities and the range of healthcare fraud cases drawing federal attention, which can inform compliance awareness and organizational risk monitoring.
Article Sections
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See DOJ’s History-Making Enforcement
This section summarizes a major federal healthcare fraud case and discusses the enforcement actions and penalties associated with it. It also places the case in the broader context of rising fraud enforcement.
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Here’s the Rest of That Week’s Top Takedowns
This section provides a roundup of additional enforcement actions from multiple states and federal entities. It highlights the variety of allegations, defendants, and agencies involved in the week’s healthcare fraud cases.
What You Will Learn
- How September healthcare fraud enforcement activity was characterized by federal agencies
- What kinds of enforcement actions were highlighted across several states
- Which federal and state organizations were involved in the takedowns
- How the article frames fraud and abuse trends for compliance audiences
Who Should Read This
- Compliance officers
- Medical coders
- Billing and reimbursement staff
- Healthcare auditors
- Practice administrators
- Healthcare attorneys
- Revenue integrity professionals
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