As the imperative to clamp down on hospital spending grows, government investigators are likely to start wielding the False Claims Act even more aggressively than in the past.
Federal officials already had frequently touted the law as the most effective tool to fight fraud and overbilling in Medicare and Medicaid because it financially rewards insiders for going public with information about how companies rip off federal programs. But experts say several simmering trends are set to escalate dramatically in 2014 and put the anti-fraud law at the fore. Among these: its increased use in Stark law cases and the new False Claims Act liability under a repayment rule known as the “60-day rule” in the Patient Protection and Affordable Care Act.