Knowing how healthcare regulations impact operations is important. The government’s use of these regulations is generally guided by two things. First, the language of the law. The provisions, definitions, and information within the actual law give us the initial round of information we need to know how the law will work in our practices and healthcare centers.
Second, the application of the law. This information is generally provided by following how the courts apply the law when challenged in court. This is why it is important to stay up to date on how the court is ruling in these types of cases.
A recent example involving an addiction treatment center is of note because lawmakers have passed new laws that specifically address this sector of the healthcare marketplace. This signals that the government is working to crackdown on wrongdoing within addiction treatment centers. Which brings us to our first lesson.
1. The government is cracking down on addiction centers
In this case, the prosecution claims the operators of an addiction treatment center perpetrated a scheme that defrauded the government millions. Within the government’s statement on the case, a representative argued that this case stood out because in addition to defrauding the government the actions of the addiction center’s owners allegedly also kept treatment from a particularly vulnerable population – those seeking treatment for addiction. The attorney went on to call this a “particularly pernicious” crime.
This type of strong language is in line with the government’s focus on abuses by various healthcare organizations including addiction treatment centers.
2. The prosecution will look for other white collar crime charges
If money is involved, as it is in healthcare fraud cases, the government will look for evidence of additional wrongdoing like tax crimes and money laundering. In this case, the prosecution is also pursuing charges for money laundering and obstruction.
Bonus: Government relied on well-established regulations
Earlier, we noted that lawmakers recently passed new laws to help address wrongdoing within addiction treatment centers. This refers to the passage of the Eliminating Kickbacks in Recovery Act of 2018. Interestingly, the government did not use this law to pursue these charges. This is important because the new tool serves as an additional legal weapon allowing the government to go after centers that have what the government would consider questionable financial agreements with contractors and employees.
The most important take-away lesson from this post is that the government will investigate the potential for healthcare fraud within addiction treatment centers. Regular internal audits and compliance programs can mitigate this risk but those who are under investigation are generally wise to discuss defense strategies and work to protect their interests.
Attorney John Rivas is responsible for this communication