‘Get there first’ to reduce the chance of a whistleblower

Health care law trends in 2023 included a focus on telehealth, whistleblowers, physician referrals, and provider compliance. Over 95% of False Claims Act cases result from whistleblowers, and the Department of Justice reported $485 million in False Claims Act settlements from January to June 2023. The Office of the Inspector General focused on areas such as fraud involving telehealth, medical unnecessary services, and Medicare Advantage and Medicaid Managed Care integrity issues. A national taskforce reviewed telehealth orders for genetic testing and durable medical equipment, leading to $2.5 billion of the $3 billion OIG recovery. The OIG received almost 85,000 complaints from the 2023 Hotline, with over 36,000 being referred for action.

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