Why Do Ambulatory Surgery Centers Need Compliance Programs?
While it is disputed how much actual fraud and abuse exists in the health care industry, what is not questioned is the incredibly high priority the government places on this issue. One way to judge this is to look at government statistics on the number of current and pending fraud and abuse investigations. In 1999, the federal government won or negotiated more than $524 million in judgments and settlements in health care fraud and abuse cases and administrative proceedings. There were 2,278 civil matters pending in 1999, and Federal prosecutors also filed 371 criminal indictments in health care fraud and abuse cases — a 16% increase over 1998. Whistleblower lawsuits are a specific category of fraud and abuse lawsuits under a federal statute called the Federal Civil False Claims Act. These whistleblower lawsuits, filed secretly under seal by individuals on behalf of the United States government, allege that government contractors (including Medicare, Medicaid, and other federal health c
