December 4, 2020
HHS Announces False Claims Act Working Group to Enhance Efforts to Combat Fraud and Focus Resources on Bad Actors
Today, the Department of Health and Human Services (HHS) announced the creation of a False Claims Act Working Group (Working Group) that enhances its partnership with the Department of Justice (DOJ) and the HHS Office of Inspector General (OIG) to combat fraud and abuse by identifying and focusing resources on those who seek to defraud the American taxpayers. HHS regulates over a third of the United States economy. In 2020, HHS provided over $1.5 trillion in grants and other payments to public and private recipients, including for healthcare items and services. In addition, HHS is one of the largest government contractors, paying over $170 billion in 2020 to thousands of contractors. In combating COVID-19, HHS has administered unprecedented levels of taxpayer support for private individuals and organizations.
“Fraud on the federal government is not a victimless crime. Every dollar that goes to fraudsters is a dollar not being used for the important work that HHS programs do for the American people, including to fight COVID-19,” said HHS Secretary Alex Azar. “This working group strengthens our partnership with DOJ and OIG on using the False Claims Act to pursue bad actors and protect taxpayer funds. Ensuring that resources are focused on bad actors will deter would-be fraudsters and avoid burdening those working in good faith to comply with the law.”
Originally enacted in response to defense contractor fraud during the American Civil War, the False Claims Act is now one of the government’s most potent tools to pursue those who defraud government payment programs. Under the False Claims Act, those who knowingly submit false claims to the government may be liable for treble damages plus penalties, which may range from approximately $11,000 to $23,000 per false claim. The United States may pursue such actions on its own, or a private citizen may file a False Claims Act suit on behalf of the government and receive a portion of the recovery.
As the agency administering various programs involving the payment of significant amounts of money to private parties, HHS is in a unique position to work with DOJ to identify and assess potentially fraudulent activities. The HHS Office of the General Counsel (OGC) created the False Claims Act Working Group to strengthen the working relationship with DOJ. The group is comprised of former DOJ False Claims Act and healthcare fraud prosecutors, former private counsel for healthcare and life sciences companies, and HHS attorneys with extensive experience with HHS’ most vulnerable payment programs. In close coordination with DOJ and OIG, the Working Group seeks to protect government funds by identifying potential False Claims Act violations and referring them to DOJ and OIG. The Working Group also will aid DOJ and OIG in False Claims Act actions by providing HHS’ views on the intricate legal frameworks of the agency’s numerous funding programs. See Department of Justice Manual 4-4.110.
The close coordination with DOJ and OIG will focus resources on those bad actors who seek to defraud HHS’ programs. That need for close coordination is always important but has taken on even greater salience now, as HHS administers significant supplemental funds to combat a historic pandemic. The vast majority of private individuals and organizations have used those funds in good faith to combat the pandemic and maintain and strengthen our healthcare system. HHS is proud to work with many of them on a regular basis. For example, through Operation Warp Speed, HHS has provided billions of dollars for COVID-19 vaccine and therapeutics research, development, distribution, and administration. Through the Provider Relief Fund, HHS has provided over $100 billion to healthcare providers, including many who are on the front lines of the pandemic response.
The Working Group will take a number of steps to enhance the mission shared with DOJ and OIG of preventing fraud and abuse and targeting resources toward the bad actors defrauding the American taxpayer. The Working Group will provide enhanced and targeted training to the HHS programs that are most vulnerable to fraud and abuse. This training will allow OGC attorneys and HHS program operators to better detect and refer potential false claims to DOJ and OIG. Working with OIG, the Working Group will also provide a focal point within the agency for consultation about legal requirements and recommendations about alleged violations. The Working Group is the conduit to HHS’ over 600 subject-matter attorneys and their agency clients, who have expertise in HHS’ funding programs.
The Working Group will strengthen the effective partnership between components of HHS and DOJ, especially as HHS and the nation face unprecedented challenges.