Federal Fraud and Abuse Laws

“The five most important Federal fraud and abuse laws that apply to physicians are the False Claims Act (FCA), the Anti-Kickback Statute (AKS), the Physician Self-Referral Law (Stark law), the Exclusion Authorities, and the Civil Monetary Penalties Law (CMPL). Government agencies, including the Department of Justice, the Department of Health & Human Services Office of Inspector General (OIG), and the Centers for Medicare & Medicaid Services (CMS), are charged with enforcing these laws. As you begin your career, it is crucial to understand these laws not only because following them is the right thing to do, but also because violating them could result in criminal penalties, civil fines, exclusion from the Federal health care programs, or loss of your medical license from your state medical board” (OIG HHS website, n.d.). Review the four most important Federal fraud and abuse laws on the OIG website (Links to an external site.). Find a Press Release on the United States Department of Justice website (Links to an external site.) related to one of the five Federal fraud and abuse cases. You will provide a summary of your chosen Press Release and the Federal fraud and abuse law that was violated Take into consideration your chosen career path (Medical Assistant, Medical Office Administrator, Medical Billing & Insurance Specialist, Medical Coder) and answer the following question: What steps would you take if you had been asked to participate in the fraudulent activity described in your chosen Press Release?

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