DOJ's review of fraud prosecution process may have healthcare implications

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Healthcare fraud policies may undergo changes following a recently announced review of prosecution methods by the Department of Justice, according to some observers.

The review will reevaluate the Yates Memo, which was drafted in 2015 to hold individuals more responsible in fraud cases, Deputy Attorney General Rod Rosenstein shared in a speech given earlier this month. The review will “evaluate whether the existing policy accomplishes its goals and best meets our current needs,” Rosenstein said.

The result of that review could be a more consistent and comprehensive way to prosecute individuals and organizations charged with crimes, including healthcare fraud, Gejaa Gobena, former deputy chief of the DOJ criminal division's fraud section, told Bloomberg BNA. The review also may fix the “unintended consequences” of the Yates policy, such as the “gray area” of how organizations should handle DOJ inquiries into its executives, Melissa Jampol, a former assistant attorney for the U.S. Attorney's Office for the District of New Jersey, told Bloomberg.

Experts predicted earlier this year that the DOJ wasn't showing signs of lightening up on individual executives in healthcare fraud cases, since it was likely the Yates memo would “stick around under the new administration.”