Justice Department seeks individual liability in healthcare fraud
- The U.S. Department of Justice announced in a memo last week it aims to combat corporate misconduct by seeking accountability from the individuals who perpetrated it.
- Companies will now have to disclose further information in order to meet the requirements for cooperation credit, which trades cooperation for more lenient penalties.
- Experts tell Modern Healthcare the change could assist the government in ongoing battle against healthcare fraud.
Dive Insight:
Individual liability has been the missing piece in combating healthcare fraud, according to former government prosecutor Marc Raspanti, a partner at Pietragallo, Gordon, Alfano, Bosick & Raspanti.
“If they do follow the new guidelines, it could very well be a sea change in certainly the way healthcare companies conduct their business and how healthcare companies ramp up their internal compliance,” he told Modern Healthcare.
According to Roy Snell, CEO of the Health Care Compliance Association, healthcare companies are already working to improve compliance.“When the enforcement community comes into healthcare, they’re going to see a more robust effort,” he said.
The DOJ memo details six steps it intends to follow in pursuit of individual corporate wrongdoing:
- For cooperation credit, corporations must provide all relevant facts relating to the individuals involved;
- Both criminal and civil corporate investigations should focus on individuals from the beginning;
- Attorneys handling corporate investigations should be in regular communication;
- The DOJ will generally not release individuals from liability when resolving a matter with a corporation;
- DOJ attorneys should not resolve matters with a corporation without a plan for handling the related individual cases; and
- Civil attorneys should typically focus on individuals as well as the company, and look beyond the individual’s ability to pay.
Recommended Reading
Modern Healthcare: Justice Department takes aim at individuals for corporate misconduct
US Department of Justice: DOJ memo: Individual accountability for corporate wrongdoing
Filed under: General Problems
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