In the first 24 days of May, the Office of Inspector General (OIG) of the Department of Health and Human Services announced 35 criminal and civil fraud settlements with Medicare and Medicaid providers. That rate of almost 1.5 cases per day demonstrates the aggressive stand the federal government is taking against health care fraud and abuse.

Billing fraud and financial dealings that violate the Stark Law or Anti-Kickback Statute (AKS) are the two most common categories of OIG or Department of Justice (DOJ) enforcement actions. Billing fraud includes unnecessary services or overutilization, services never delivered, duplicate services and upcoding of services. Stark Law and AKS cases commonly include excessive physician compensation arrangements, equipment and office lease arrangements, and a wide range of crafty financial inducements for physicians to refer patients to home health, hospice, inpatient and outpatient services or for physicians to provide high-cost drugs.