The Department of Health and Human Services (HHS) announced the creation of a False Claims Act Working Group (Working Group) that enhances its partnership with the Department of Justice (DOJ) and the HHS Office of Inspector General (OIG) to combat fraud and abuse by identifying and focusing resources on those who seek to defraud the American taxpayers.
HHS regulates over a third of the United States economy. In 2020, HHS provided over $1.5 trillion in grants and other payments to public and private recipients, including for healthcare items and services. In addition, HHS is one of the largest government contractors, paying over $170 billion in 2020 to thousands of contractors. In combating COVID-19, HHS has administered unprecedented levels of taxpayer support for private individuals and organizations.
Originally enacted in response to defense contractor fraud during the American Civil War, the False Claims Act is now one of the government’s most potent tools to pursue those who defraud government payment programs. Under the False Claims Act, those who knowingly submit false claims to the government may be liable for treble damages plus penalties, which may range from approximately $11,000 to $23,000 per false claim. The United States may pursue such actions on its own, or a private citizen may file a False Claims Act suit on behalf of the government and receive a portion of the recovery.
As the agency administering various programs involving the payment of significant amounts of money to private parties, HHS is in a unique position to work with DOJ to identify and assess potentially fraudulent activities. The HHS Office of the General Counsel (OGC) created the False Claims Act Working Group to strengthen the working relationship with DOJ. The group is comprised of former DOJ False Claims Act and healthcare fraud prosecutors, former private counsel for healthcare and life sciences companies, and HHS attorneys with extensive experience with HHS’ most vulnerable payment programs.
In close coordination with DOJ and OIG, the Working Group seeks to protect government funds by identifying potential False Claims Act violations and referring them to DOJ and OIG. The Working Group also will aid DOJ and OIG in False Claims Act actions by providing HHS’ views on the intricate legal frameworks of the agency’s numerous funding programs. The close coordination with DOJ and OIG will focus resources on those bad actors who seek to defraud HHS’ programs. That need for close coordination is always important but has taken on even greater salience now, as HHS administers significant supplemental funds to combat a historic pandemic. The vast majority of private individuals and organizations have used those funds in good faith to combat the pandemic and maintain and strengthen our healthcare system.
