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DOJ Intends to Increase Healthcare Fraud Penalties By Almost 100%

healthcare fraudThe Department of Justice (“DOJ”) recently announced that it intends to increase healthcare fraud penalties under the False Claims Act (“FCA”) on claims assessed after August 1, 2016.

DOJ’s Justification For The Increase

FCA penalties can already be high since penalties are assessed per-claim. Each false claim presented to the government can be a separate violation. The DOJ’s Interim Final Rule would increase the minimum per-claim penalty from $5,500 to $10,781 and maximum per-claim penalty from $11,000 to $21,563.

This is a steep increase over 96%. While there was a 10% cap on the amount the penalties could increase, that law was amended by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015 (“2015 Act”). The 2015 Act also included a one-time “catch up provision” requiring the first increase be based changes in the consumer price index since the year the penalties were established.

What The Increase Means To Healthcare Providers

This increase could incentivize whistle-blowers to identify false claims because the whistle-blower may be able to keep a percentage of the money recovered. Healthcare providers billing the government need to ensure that all their practice’s policies and procedures adhere with federal and state regulations. Proactive and preventive measures are the best way to stay out of the government’s cross hairs for fraud.

How To Ensure Federal and State Compliance

We can help. Our attorneys have extensive experience in analyzing and bringing into compliance healthcare providers’ policies and procedures. We’ve helped hundred of providers – from small, independent providers to large national corporations ensure compliance with regulations such as the Anti-Kickback Statute and Stark. Contact DJ Jeyaram at or 678.325.3872 or Jonathan Anderson at

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