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As health care costs continue to accelerate and consume an ever-higher percentage of GDP, federal and state regulators are ratcheting up efforts to find fraud. According to the Deloitte Forensic Center, criminal investigations, civil investigations, civil penalties and criminal convictions are all on the rise. The threat of treble damages, higher rewards for whistleblowers and more sophisticated “data mining” techniques give regulators more weapons in their fraud-fighting arsenal.
Both for-profit and non-profit health care providers need to be alert to recent shifts in the regulatory environment that are making robust, top-to-bottom compliance with federal and state fraud laws and regulations more critical than ever.