Post Date: September 14, 2016                   Topics: Anti-Kickback Statue / Fraud and Abuse


Civil monetary penalties for violations of the False Claims Act, the Program Fraud Civil Remedies Act and the Anti-Kickback Act nearly doubled with the issuance of an interim final rule by the Department of Justice on August 1st. The minimum per claim penalty increased from $5,500 to $10,781 and the maximum per claim penalty increased from $11,000 to $21,563. The increased penalty amounts apply to penalties assessed after August 1, 2016 for violations that occurred after November 2, 2015.

After this initial adjustment, automatic adjustments for inflation will be made no later than January 15th of each following year.

The increased penalties should encourage all health care providers to focus on preventing fraud through internal monitoring and auditing. Providers should also be aware that the increase in the penalties may entice whistleblowers to pursue claims under the False Claims Act because, if successful, they are awarded a percentage of the penalties recovered.

A robust compliance program can help providers to track their efforts to comply with the relevant laws and provide internal reporting mechanisms for employees who have questions or concerns about the organization’s practices.

The interim final rule is available here.