CIVIL FRAUD RECOVERIES FY 2017-2021 ($BILLIONS)
To no one’s surprise, we have begun to see enforcement results stemming from fraud schemes associated with the trillions of dollars of pandemic-related relief. At year’s end, the U.S. Secret Service warned of “potential fraudulent activity nearing $100 billion.”
6
$5.6
5
4
$3.4
$3.1
$2.9
3
$2.2
scienter – are winding their way through the federal court system. 4 And, there is a distinct possibility that the Supreme Court will take up one or more of these issues in the coming years. To no one’s surprise, we have begun to see enforcement results stemming from fraud schemes associated with the trillions of dollars of pandemic-related relief. At year’s end, the U.S. Secret Service warned of “potential fraudulent activity nearing $100 billion.” 5 Along the way, we saw DOJ announce a number of significant Coronavirus Aid, Relief, and Economic Security (CARES) Act and COVID-19-related enforcement results. There is no question we will continue to see the government focus its efforts on uncovering and prosecuting relief-related fraud in the coming years. If the last decade of closely following healthcare fraud and abuse developments have taught us anything, we know that each year will pose new enforcement challenges for those involved in the healthcare industry. We trust that our firm’s annual Healthcare Fraud & Abuse Review will assist healthcare providers in better anticipating those challenges and understanding how those challenges can be best navigated in an ever-changing world.
2
1
2018
2019
2020
2017
2021
4 See, e.g. Estate of Helmly v. Bethany Hospice & Palliative Care LLC , 853 F. Appx. 496 (11th Cir. 2021) (affirming dismissal for failure to plead FCA claims in accordance with Rule 9(b)), petition for writ of certiorari pending No. 21-462; U.S. ex rel. Schutte v. SuperValu Inc. , 9 F.4th 455 (7th Cir. 2021) (affirming dismissal of FCA claims because defendants were alleged to have acted in accordance with an objectively reasonable interpretation of the applicable regulations precluding a determination of scienter under the FCA). 5 https://www.wsj.com/articles/thefts-of-covid-19-relief-funds-total-at-least-100-billion-secret-service- says-11640202072.
A LOOK BACK … A LOOK AHEAD BASS, BERRY & SIMS | 2
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