Health Care Fraud and Abuse

April 25, 2014 |

Health care fraud is a national problem affecting everyone in the US, either directly or indirectly, and is carried out by many segments of the health care system, including companies or individuals, using various methods. It is also a growing criminal enterprise: In Fiscal Year 2012 alone, various government teams involved in the Health Care Fraud and Abuse (“HCFAC”) Program recovered $4.2 billion dollars from individuals and companies who attempted to defraud federal health programs. And the Justice Department opened 1,131 new criminal health care fraud investigations involving 2,148 potential defendants. For the health care provider or the insurer or the companies offering health care to their employees, detecting such schemes can involve various forensic accounting techniques.

About the Author

Sareena M. Sawhney, MBA, CFE, MAFF, is a Director in the Litigation and Corporate Financial Advisory Services Group at Marks Paneth LLP. Ms. Sawhney focuses on providing services in the areas of complex fraud investigations and forensic accounting examinations as well as services related to commercial litigation and comprehensive damage analyses. She can be reached at 212.503.6372 or by email at ssawhney@markspaneth.com.