Healthcare Cos. Face Tough Choices in DOJ Fraud Campaign

Litigation attorney Bill Brady was interviewed for a Law360 article about the federal government's efforts to prosecute fraud and incentivize self-reporting throughout the healthcare industry. The article focused on three developments at the U.S. Department of Justice (DOJ): a new self-disclosure policy clarifying that companies seeking credit for voluntarily disclosing potentially criminal conduct must report to the DOJ's National Fraud Enforcement Division instead of the U.S. Department of Health and Human Services Office of Inspector General; a novel whistleblower program offering $10,000 to $30,000 in rewards for tips that lead to criminal charges; and a pilot False Claims Act (FCA) voluntary disclosure program offering organizations civil FCA liability shields.

Bill called these developments "noteworthy" but cautioned "it remains to be seen what the impact will be" and how U.S. attorneys' offices implement them. He added that though the programs may sound enticing, healthcare providers and business leaders should approach the decision to self-disclose armed with detailed factual and legal analyses along with a thorough understanding of their own data and internal processes for identifying and rectifying misconduct.

"There's always pressure on companies and lawyers who are helping to work through these issues, and I think this [policy change] likely does add to that pressure," he said. "Particularly with healthcare and in the white collar world, it can be challenging to draw that line."

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