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July 13, 2022

Around the nation: DOJ, HHS recovered more than $5 billion in health care fraud in 2021

Daily Briefing

    The Department of Justice (DOJ) and HHS recovered over $5 billion in health care fraud settlements and judgements during fiscal year (FY) 2021, in today's bite-sized hospital and health industry news from the District of Columbia, Minnesota, and Missouri.

    • District of Columbia: DOJ and HHS in FY 2021 recovered over $5 billion in health care fraud settlements and judgements—the largest amount of money the program has ever recovered—according to the joint annual government Health Care Fraud and Abuse Control Program Annual Report. During FY 2021, DOJ opened 831 new criminal health care fraud investigations, which resulted in nearly $1.9 billion in judgements and settlements being returned to the federal government or private citizens. Of the $1.9 billion recovered, $1.2 billion went to the Medicare trust fund, and around $98.6 million went to CMS. In total, federal prosecutors filed criminal charges in 462 cases with 741 defendants. Of those, 312 defendants were convicted of crimes related to health care fraud. (Eddy, Healthcare Finance News, 7/11)
    • Minnesota: Mayo Clinic Laboratories on Monday started testing for monkeypox, according to an announcement from CDC. Health care providers can order tests from the laboratory, like they would for other tests. Results will be reported to jurisdictions in accordance with CDC's reporting guidelines. The laboratory plans to process up to 10,000 CDC orthopoxvirus tests each week. Notably, LabCorp last week started using CDC's test, and three other commercial laboratories will soon join CDC's Laboratory Response Network in processing the monkeypox test. "This will not only increase testing capacity but also make it more convenient for providers and patients to access tests by using existing provider-to-laboratory networks," said CDC Director Rochelle Walensky. (AHA News, 7/11)
    • Missouri: St. Luke's Hospital system on Monday named Andrew Bagnall as its new president and CEO. Bagnall, who has over 25 years of industry experience, most recently served as president and CEO of Sisters Health System. He succeeds Gary Olson, who is stepping out of the role after years of service. "Andrew Bagnall has extensive leadership experience and a track record of success in health systems, community hospitals, and long-term acute care settings," said David Price, board chair of St. Luke's Hospital. "Andy shares St. Luke's passion for providing the highest quality patient care, maintaining our unique position as the St. Louis community's only independent health care network, and nurturing our excellent workplace culture." (Gonzalez, Becker's Hospital Review, 7/11)

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