Enforcement Trends to Expect Post-Lockdown

With the COVID lockdown, the law enforcement agencies, including the United States Department of Justice (DOJ), the local US Attorneys’ Offices, and the state enforcement agencies worked on a limited basis for much of 2020 and 2021 to present date. The slowdown in enforcement in 2020 due to the pandemic was reflected in the civil fraud recoveries for that year. The DOJ reported $2.2 billion in settlement and judgments for civil cases in the fiscal year 2020 (from October 1, 2019, to September 30, 2020), which was down from the over $3 billion recovered in the fiscal year 2019 and was the lowest civil fraud recovery in a decade. The percentage of healthcare recovery was higher, totaling approximately $1.8 billion in 2020, or over 80% of the recovery of all civil fraud cases.

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Reporting Crimes Against Patients

The HIPAA privacy rules have a number of disclosure exceptions, but those exceptions are only effective when state law also allows the disclosure. When there is no state-law exception, it is irrelevant that HIPAA would allow the disclosure. One such common situation involves crimes against patients. Continue reading

Louisiana Health Insurance Exchange Roll-Out Includes Some Interesting Questions

In November, 2012, Louisiana health officials declined to create a state-run exchange, leaving it to the federal government to operate a marketplace for Louisiana residents. Only recently has any real clarity on the structure of the Louisiana Health Insurance Exchange been available for its October 1, 2013 opening date. Continue reading