Healthcare Enforcement and Compliance: A Look at 2023 Trends

Regulatory and enforcement agencies are using more sophisticated tactics to identify and combat healthcare fraud, including data analytics and inter-agency initiatives, and leveraging the False Claims Act (FCA) – the government’s primary civil fraud enforcement tool – to do so. This overview, Healthcare Enforcement and Compliance: A Look at 2023 Trends, summarizes some of the most notable FCA investigations, settlements, and judgments in 2023 so far, including cases and trends relating to Medicare, Medicaid, and TRICARE and involving claims for services not rendered, unnecessary services, substandard care, upcoding, unlawful kickbacks and bribes, and improper marketing and co-management arrangements.