HEALTH CARE FRAUD

The federal and state efforts to combat health care fraud is examined. Section II of the article discusses the statutes Congress enacted specifically to address Medicare and Medicaid fraud and reviews the elements, defenses, penalties, and safe harbor provisions for each offense. Section III discusses the general federal statutes the government uses to prosecute all types of health care fraud, including those regulating false claims, false statements, and mail and wire fraud, and reviews the elements, defenses, and penalties of each offense. Section IV provides an overview of federal and state government agencies' enforcement efforts to investigate and prosecute health care fraud.