Enforcement and Health Care Technology: Navigating Fraud and Abuse Issues in Emerging Digital Health Care Areas

Like many industries, the health care industry has become increasingly digitized and reliant on technology. Technology advancements also have had a major effect on enforcement. In his comments to the Federal Bar Association on February 17, 2021, Acting Assistant Attorney General Brian M. Boynton described the benefits of data analytics to the government when choosing how to use its enforcement powers. Although the role of the traditional whistleblower has not been usurped, the increased focus of the Department of Health and Human Services (HHS) Office of Inspector General (OIG), Civil Division attorneys, and local Assistant U.S. Attorneys on Medicare data outlier costs and diagnostic code usage trends cannot be ignored. And while the government relies on data analytics to uncover potential fraud, it has also applied particular scrutiny to health care companies’ own use of technology that could be used to commit potential fraud. Suffice to say, companies entering the tech space should be forewarned and proceed cautiously.

Republished with permission. The full article for, "Enforcement and Health Care Technology: Navigating Fraud and Abuse Issues in Emerging Digital Health Care Areas," was published in Health Law Weekly by the American Health Law Association (AHLA) on August 20, 2021.