Date: February 24, 2022
Lexology and other media reported on the Federal Bar Association's fifth annual Qui Tam Conference, which covered topics from telemedicine to cybersecurity. TELG's Scott Oswald helped organize the conference in his role as the section's chair.
FBA’s 2022 Qui Tam Conference Puts Annual Spotlight on FCA Enforcement Trends and Developments
On February 23, 2022, the Federal Bar Association (FBA) kicked off its fifth annual Qui Tam Conference to highlight key areas for False Claims Act (FCA) enforcement in the coming year. The conference opened with a keynote address by Gregory E. Demske, Chief Counsel to the Inspector General, Department of Health and Human Services (HHS), Office of Inspector General (OIG). Then, a series of panels analyzed the FCA-related developments from the prior year, recent efforts by the U.S. Department of Justice (DOJ) to combat cybersecurity fraud, and some of the schemes promoting alleged telehealth fraud during the ongoing COVID-19 public health emergency. Based on the comments of government speakers, all speaking in their individual capacities, below are key takeaways of what we expect the government to prioritize in 2022:
Pandemic-related fraud and telehealth fraud are key targets
Telehealth Fraud Not An Easy FCA Target, DOJ Attys Say
From Law360 (February 23, 2022)
The False Claims Act will increasingly be wielded against bogus billing for telehealth services that surged in popularity amid COVID-19, but the law’s use has been hindered by complex and sophisticated fraud schemes, U.S. Department of Justice attorneys said Wednesday.
The DOJ lawyers outlined their forecast and frustrations at the Federal Bar Association’s 2022 Qui Tam Conference during a session focused on “the rapidly increasing problem of telehealth fraud” in Medicare since the coronavirus pandemic began two years ago.
David Wiseman, an assistant director in the fraud section of the DOJ’s Civil Division, said during Wednesday’s virtual session that such scams have been spreading “like wildfire.” The ripoffs frequently stem from convoluted arrangements in which sham telemedicine companies get doctors to write unwarranted prescriptions that are sold and used to bill Medicare for medically unnecessary goods, Wiseman said.
Investigations Newsletter: DOJ Attorneys Comment on the Rise of Telehealth Fraud During the COVID-19 Pandemic
From JD Supra (February 28, 2022)
During the 2022 Qui Tam Conference of the Federal Bar Association, DOJ attorneys commented on the dramatic rise in the use of remote health care services during the COVID-19 pandemic, and the difficulty in bringing civil False Claims Act (FCA) actions against fraudulent telehealth schemes. The number of telehealth users increased from around one million unique users between March 2019 to February 2020, to 28 million unique users in the following year. According to DOJ attorneys, this increase in the use of remote health care services also brought a significant increase in fraudulent schemes that often involve the use of sham companies having doctors write unnecessary prescriptions that are billed to Medicare. DOJ attorneys noted that the use of complex agreements and the frequent involvement of cross-border syndicates make it difficult to bring successful civil FCA actions against these schemes.
Covid Aid, Managed Care Top Fraud Priorities for HHS Watchdog
From Bloomberg Law (February 23, 2022)
Health-care providers who unlawfully claim Covid-19 relief funds, managed care companies that overbill Medicare, and telemarketers that talk patients into services they don’t need are all investigative priorities for the Department of Health and Human Services’ top watchdog.
The HHS Office of Inspector General is pursuing civil monetary penalty cases for fraud on the Covid-19 Provider Relief Fund, Gregory Demske, chief counsel to the HHS IG, said during the Federal Bar Association’s 2022 virtual qui tam conference on Wednesday. It already has settled five such cases, he said.
“People had false certifications; they were not entitled to money that they received,” he said.