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Insurance Fraud Remains Key Area of Government Focus
The year 2021 will be remembered for many things, of course including that, as of this writing, a total of more than 800,000 Americans have died from COVID-19 since the beginning of the pandemic. For lawyers who represent insurance companies in cases seeking to challenge fraudulent claims and other types of insurance fraud, as well as for the federal and state attorneys who are on the front lines battling the same problem, 2021 also is likely to be recalled as the "Year of Insurance Fraud."
Consider that during the past year there were important government reports examining the defrauding of health insurance programs, new trends and government initiatives relating to fraud, and insurance fraud cases involving significant numbers of defendants, others where extraordinarily large amounts of money were at issue, or both. When added together, it is not difficult to understand why insurance fraud remains such a key area of focus for government officials, carriers and attorneys.
Government Reports
Nearly one year ago, in mid-January, the U.S. Department of Justice (DOJ) announced that it obtained more than $2.2 billion in settlements and judgments from civil cases involving fraud and false claims against the government in the fiscal year ending Sept. 30, 2020. See, DOJ Justice Department Recovers Over $2.2 Billion from False Claims Act Cases in Fiscal Year 2020 (Jan. 14, 2021). Of that amount, over $1.8 billion related to federal health insurance programs such as Medicare, Medicaid and TRICARE, the health care program for service members and their families. The defendants involved included drug and medical device manufacturers, managed care providers, hospitals, pharmacies, hospice organizations, laboratories and physicians.
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