This article was reprinted with permission from the June 1998 issue of The Metropolitan Corporate Counsel magazine. By Eric Kraeutler and Lisa A. Mathewson Civil and criminal liability for health care fraud and abuse is a serious and growing risk in all corners of the health care industry.
Smaller operations are no less at risk.
Given the complexity of the regulatory environment, the vigor of the enforcement efforts, and the severity of the sanctions for fraud and abuse, minimizing the risk of a violation and reducing liability should be a top priority for anyone operating in the health care field. More recently, the HHS-OIG has become increasingly insistent that the private health care community should help to combat fraud and abuse through voluntary compliance programs designed to prevent, detect and respond to violations. The prospective benefits to an organization are twofold. First, a compliance plan will help to prevent violations, or reveal them in time to minimize their impact. Federal prosecutors will consider favorably an organization's genuine efforts to prevent wrongdoing, as reflected in its compliance program, when making charging decisions.