Medicare Fraud and Abuse:

DOJ Has Made Progress in Implementing False Claims Act Guidance

HEHS-00-73: Published: Mar 31, 2000. Publicly Released: Mar 31, 2000.

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William J. Scanlon
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Pursuant to a legislative requirement, GAO reviewed the Department of Justice's (DOJ) compliance with the False Claims Act guidance, focusing on: (1) what DOJ has done in response to GAO's prior recommendations; and (2) DOJ's Laboratory Unbundling Initiative.

GAO noted that: (1) since GAO's August 1999 report was issued, DOJ has taken actions to improve its oversight of the U.S. Attorneys' Offices participating in national health care initiatives; (2) it plans to place more emphasis on offices' compliance with the False Claims Act guidance in its periodic evaluations of these offices and has initiated a requirement for offices to certify their compliance annually; (3) DOJ officials also told GAO that the role of the working groups has been expanded; (4) originally, these groups--composed of DOJ attorneys and Assistant U.S. Attorneys--concentrated on coordinating the development and implementation of national initiatives; (5) now enhanced emphasis is being placed on monitoring compliance with the guidance; (6) in addition, DOJ has given special attention to the most problem-prone initiative, Laboratory Unbundling; (7) offices participating in this initiative at the time the guidance was issued were recently required to document their compliance; and (8) the four U.S. Attorneys' Offices that GAO previously reported as being slow to incorporate the guidance into their ongoing Laboratory Unbundling investigations now appear to have addressed their shortcomings.

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