By: Christopher A. Parrella, Esq., CPC, CHC, CPCO
Parrella Health Law, Boston, Mass.
The Health Care Fraud and Abuse Control Program (HCFAC) Annual Report for Fiscal Year 2022 details the efforts and achievements of the program in combating health care fraud and abuse. The program, in its 26th year, continues to demonstrate the effectiveness of a collaborative approach to identifying and prosecuting significant health care fraud cases, preventing future fraud and abuse, and protecting beneficiaries.

In Fiscal Year 2022, civil health care fraud settlements and judgments under the False Claims Act surpassed $1.6 billion. Total recoveries, including other health care administrative impositions won or negotiated, amounted to more than $1.7 billion returned to the Federal Government or paid to private persons. The Medicare Trust Funds received over $1.2 billion, and the Federal Medicaid program had over $126.1 million transferred to the Centers for Medicare & Medicaid Services (CMS).

Enforcement actions included the opening of over 809 new criminal health care fraud investigations by the Department of Justice (DOJ), with more than 419 cases filed and at least 680 defendants. Over 477 defendants were convicted of health care fraud-related crimes. Additionally, DOJ opened over 774 new civil health care fraud investigations and had over 1288 civil health care fraud matters pending. The Federal Bureau of Investigation’s efforts led to over 499 operational disruptions of criminal fraud organizations and the dismantlement of more than 132 criminal enterprises.

The Health and Human Services Office of Inspector General (HHS-OIG) conducted 661 criminal actions and 726 civil actions, including false claims and civil monetary penalty settlements, leading to the exclusion of 2332 individuals and entities from Federal health care programs.

The report also outlines the impact of sequestration, statutory background, and program goals. It provides detailed accounts of expenditures, including mandatory and discretionary funding allocations, and showcases the efforts of departments within Health and Human Services and the Department of Justice.

There is also an extensive section on significant criminal and civil investigations, highlighting cases across various categories such as clinics, COVID-19 related enforcement, diagnostic testing, drug companies, and more. The report concludes with appendices and a glossary of common terms used throughout the document.

Download the HCFAC Annual Report for Fiscal Year 2022:
sandbox:/mnt/data/FY2022-hcfac.pdf

For professionals navigating the complexities of healthcare law, the report is an invaluable resource that highlights the consequences of non-compliance and the significance of maintaining ethical practices. At Parrella Health Law, we remain committed to guiding our clients through the legal landscape with the insight needed to foster compliance, mitigate risks, and uphold the integrity of our healthcare system. Download the full HCFAC Annual Report to gain a comprehensive understanding of the current state of healthcare fraud and abuse control and to ensure your practices align with the highest standards of legal and ethical responsibility.