Welcome to the first Allegiant Experts blog post of 2019! We hope you enjoyed your holiday season and also hope that 2019 has started off well for you. As we begin a new year, the Allegiant Experts team is renewing its commitment to helping lawyers trying health care fraud cases locate the clinical expertise they need to find fair and accurate results.
With that said, we hope that 2019 will see a decline in overall health care fraud incidents throughout our country. However, if history has taught us anything, it’s that “wishful thinking” is the best way to describe the previous sentence. In 2018, health care fraud was rampant. But, we’re also happy to report that health care fraudsters were taken down in record numbers.
2018 was a bad year to be a health care fraudster.
Those exact words started a recent article by Jennifer Bresnick on HealthpayerIntelligence.com. In it, she announces that the United States Department of Justice recovered no less than $2.5 billion under the False Claims Act last year. This is an excellent total considering that $2.8 billion was lost due to fraud and improper claims from health care providers during the fiscal year.
Bresnick notes that 2018 marked the ninth consecutive year that civil health care fraud settlements and judgments have topped $2 billion – even though millions of dollars recovered for state Medicaid entities weren’t included in the whopping total. According to the DOJ, the largest monetary recoveries of 2018 involved the drug and medical device industries.
“In one of the biggest recoveries of 2018, AmerisourceBergen Corporation and certain subsidiaries paid $625 million to resolve allegations of repackaging drugs intended for cancer patients and profiting from the action,” reports Bresnick, “In a separate case, Alere agreed to pay $33.2 million to resolve allegations of selling unreliable testing devices for use in the diagnosis of drug overdoses and other conditions.”
Medicare, Medicaid and TRICARE endured numerous schemes.
Many of the settlements and judgments that took place last year recovered money for the three above mentioned health insurance programs. Readers of the Allegiant Experts Blog are no strangers to reports involving fraudsters ripping off these great institutions.
As Bresnick reveals, “more than 600 defendants, including 165 doctors, nurses, and other licensed professionals, were charged with committing fraud schemes totaling more than $2 billion in false billings to Medicare, Medicaid, TRICARE, and private insurance companies – nearly equaling the sum total of other recoveries during the past 12 months.”
You may also remember that 2018 was the year of the single largest health care fraud takedown in history. As reported by the DoJ in June, 601 charged defendants across 58 federal districts were charged for their alleged participation in health care fraud schemes.
Are you an attorney who is currently trying a health care fraud case?
Please don’t hesitate to contact Allegiant Experts to find out how our clinical expertise may help your case. Our experts have been providing expert clinical services for nearly two decades and can help your team by bridging the disciplines of medicine, coding and billing to ensure accurate payment and data is achieved. Call us at 407-217-5831 or email us at info@allegiantexperts.com.