Report: More FCA, anti-kickback cases expected in 2016

Share this content:

Healthcare providers can expect the new year to bring an increase in False Claims Act cases and beefed-up enforcement anti-fraud regulations, according to a new report.

Large settlements in whistleblower suits and revisions to the anti-kickback Stark law will create an increase in the number of FCA suits filed in the coming year, experts agreed in Bloomberg BNA's 2016 fraud outlook, released Friday.

The recent federal push targeting individuals for fraud, rather than the whole company, is also likely to create waves over 2016, the report said. That push may make it difficult for companies to carry out their own fraud investigations, and impact settlements, attorney Kevin Mcananey told Bloomberg.

A new rule also starts this year that would require providers to return overpayments and notify the agency the payment was returned to within 60 days of first identifying the overpayment. The final rule is expected to be released in February.

Final revisions to a rule that would increase the Office of Inspector General's ability to impose civil monetary penalties, and one that would form a new anti-kickback statute for some Medicare Part D activities are also expected in 2016.

The top fraud issues for 2016 also include a crackdown on specialty pharmacy fraud, kickbacks to pharmaceutical and medical device companies and increased attention on defective medical devices, Bloomberg reported.