Fraud prosecutions low, but settlements high, lawyer says

Healthcare fraud prosecutions are down, but convicted firms are paying higher settlements and civil penalties, some attorneys say.

The government has not generally succeeded in prosecuting healthcare fraud cases, admitted Kevin G. McAnaney. He spoke at the American Bar Association’s Health Care Fraud Institute. But even without convictions, providers have had to pay significant penalties in cases brought by the government, he said.

Confusion among jurors partially accounts for the recent lack of success in federal criminal prosecutions, especially in cases brought under anti-kickback laws. Jurors are having difficulty understanding “intent” as it is legally defined, another lawyer said.