On December 4, 2020, the U.S. Department of Health and Human Services (HHS) announced the creation of the False Claims Act Working Group (FCA Working Group).  The federal False Claims Act (FCA) has remained one of the federal government’s top tools to investigate and punish alleged fraud, waste, and abuse in federal programs.  In fiscal year 2019, the Department of Justice (DOJ) collected over $3 billion in settlements and judgments under the FCA.  CG attorneys have written about the government’s continued use of the FCA during the COVID-19 pandemic.  

The creation of the FCA Working Group shows the government’s continued reliance on and acknowledgment of the FCA as a powerful tool and evidences it continued strategic use of cross-agency partnerships to wield that tool.  One reason HHS’ Office of the General Counsel created the FCA Working Group is to strengthen the working relationship with DOJ.  The FCA Working Group includes former DOJ lawyers and healthcare fraud prosecutors, a former private counsel for healthcare and life sciences, and HHS attorneys.  As part of its responsibilities, the FCA Working Group will identify potential FCA violations and refer those cases to the DOJ.

The new FCA Working Group will partner with the DOJ and HHS’ Office of Inspector General (OIG) “to enhance the mission shared with DOJ and OIG of preventing fraud and abuse.” To further the shared goals of fraud and abuse prevention, detection, and prosecution, the FCA Working Group will also provide targeted training and resources concerning HHS programs vulnerable to fraud and abuse.  The targeted training will help HHS attorneys better detect and refer potential FCA cases.  The FCA Working Group will serve as a “focal point” within the agency for consultation regarding the legal framework of various federal funding programs.  As described by HHS, the FCA Working Group is “the conduit to HHS’ over 600 subject-matter attorneys and their agency clients, who have expertise in HHS’ funding programs.”  According to HHS Secretary Alex Azar, “[t]his working group strengthens our partnership with DOJ and OIG on using the False Claims Act to pursue bad actors and protect taxpayer funds.  Ensuring that resources are focused on bad actors will deter would-be fraudsters and avoid burdening those working in good faith to comply with the law.”

Through cross-agency collaborations, the government has taken significant enforcement actions.  In October 2020, CG attorneys wrote about a nationwide enforcement action involving 345 defendants allegedly responsible for submitting more than $6 billion in fraudulent healthcare claims.  This nationwide enforcement action involved collaboration between various federal and local agencies.  HHS Deputy Inspector General Gary Cantrell’s explained, “collaboration is critical in our fight against health care fraud.  We will continue working with our law enforcement partners to hold accountable those who steal from federal health programs and protect the millions of beneficiaries who rely on them.”  The new FCA Working Group is another example of the federal government utilizing cross-agency collaborations and resources.  Businesses and individuals, particularly those in the healthcare industry, must remain vigilant in their compliance efforts and in addressing potential fraud and abuse concerns.  The government’s use of the FCA, cross-agency collaborations, and enforcement actions will continue to increase. 

The attorneys at Chilivis Grubman represent clients of all types and sizes in connection with government investigations, both criminal and civil, and False Claims Act litigation.  If you need assistance with such a matter, please contact us today.