In a shift still evolving, federal enforcers are targeting individual executives in health care fraud cases that used to be aimed at their corporations, The Associated Press reports.
The new tactic is raising the anxiety level – and risks – for executives at drug companies, medical device manufacturers, nursing home chains and other health care enterprises that deal with Medicare and Medicaid.
Previously, if a company got caught, its lawyers in many cases would be able to negotiate a financial settlement. The company would write the government a fat check and promise not to break the rules again. Often the cost of the settlement would get passed on to customers.
Now, on top of fines paid by a company, senior executives can face criminal charges even if they weren’t involved in the scheme but could have stopped it had they known. Furthermore, they can also be banned from doing business with government health programs, a career-ending consequence.
Many in industry see the more aggressive strategy as government overkill, meting out radical punishment to individuals whose guilt prosecutors would be hard pressed to prove to a jury.
The feds say they were frustrated by repeat violations and decided to start using enforcement tools that were on the books but had been ignored By some estimates, health care fraud costs taxpayers $60 billion a year, galling at a time when Medicare faces insolvency.
