Civil Money Penalties: Reasonable Penalties to Combat Fraud or a Strain on the Health Care Community

Your typical healthcare fraud claim involves gross billing or filing a reimbursement claim for services not rendered. Implemented in response to capacious litigation, federal fraud and abuse laws have raised “a number of analytical and practical challenges for both” health care providers and the legal community at large. Due to this rising frequency of healthcare fraud, millions of dollars are lost annually and the quality of healthcare services has diminished. Recently, the enactment of the Affordable Care Act has been met with great resistance and criticism. However, prior to the enactment of this comprehensive healthcare reform legislation, Congress enacted numerous federal fraud and abuse laws. This laundry list of federal fraud and abuse laws instituted by Congress, include Stark Law, Anti-Kickback Statute, the False Claims Act, Exclusion Statute and Civil Money Penalties Law. In addition to criminal prosecution, various statutes and regulations impose severe fines and penalties. Perhaps the most significant and preferred measure in the battle against healthcare fraud undertaken by Congress is the imposition of Civil Money Penalties, as this deterrent measure is continually evolving.

Photo Credit: Images_of_Money / Foter / CC BY