I recently authored an article for the American Bar Association (ABA) Health Law Section regarding healthcare fraud enforcement trends in 2024 and the projected issues for 2025, which highlights the Department of Justice’s (DOJ) increasing focus on fraud, waste, and abuse.
“The consistent messaging from political appointees and relevant DOJ officials points to a heavy focus on fraud, waste, and abuse through increased enforcement under the False Claims Act in healthcare and beyond,” I explained in the article. I detailed how the DOJ is expanding its enforcement efforts to tackle pandemic relief fraud and cybersecurity issues.
“Perhaps the key takeaway from the DOJ report, however, is that the government’s fraud enforcement initiatives are diversifying,” I said. “While healthcare has historically comprised around 80% of the total recoveries, in 2024, it made up just 60%.”
In the article’s conclusion, I noted that although there have been staffing reductions, the Trump administration is increasing healthcare enforcement efforts. They are utilizing the False Claims Act to address issues like kickbacks, upcoding, and other forms of billing fraud, while also investigating new strategies for tackling civil fraud.
The full article, “Healthcare Fraud Enforcement Trends from 2024 and Issues to Watch in 2025,” was published by ABA Health Law on June 4 and is available online (subscription required).