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ARTICLE · 31 JULY 2001

Are Compliance Plans Mandatory? You Decide

United StatesLitigation, Mediation & Arbitration

By David L. Schick Esq. and David B. Canning Esq.

The federal government has made it a top priority to crack down on waste, fraud and abuse in the federal health care programs.  In 2001, the OIG estimates that over $2 billion will be recovered from providers for fraud and abuse—up from $750 million in 1998.  In 2000, the government excluded 3,350 physicians from the federal health care programs and prosecuted 414 physicians.  A look at the size and frequency of recent physician settlements demonstrates the government's aggressiveness is escalating.

Penalties and government incentives.

  Physician practices of all sizes across the United States are settling at an increasing rate with the federal government for astounding amounts of money due to false claims allegations.  The False Claims Act is the primary enforcement tool for the government, allowing either the government or private citizens to bring civil actions against physicians for filing false claims.  The Act provides for

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