The Justice Department is focusing on private equity’s role in causing healthcare fraud, the head of the Civil Division said Thursday.
“We have already had a few cases involving private equity firms, and given the significant role that private equity is increasingly playing in the healthcare field, we anticipate that their impact on healthcare billings will continue to grow as well,” said Brian Boynton, the Civil Division’s top official, in remarks prepared for delivery at a legal conference in Washington.
The department’s civil investigators are increasingly noticing private equity, venture capital, and other investing sources influencing medical provider behavior, he said. They do this by “providing express direction for how a provider should conduct their business, or more indirectly by providing revenue targets or other indirect benchmarks intended to prioritize reimbursement.”
While noting that private equity and other third-parties aren’t inherently problematic for the healthcare industry, Boynton said they can also “undermine medical judgment” and cause healthcare companies to submit false claims to the government.
“The Department will not hesitate to pursue” private equity firms “for their roles in defrauding the government,” Boynton added.
He made his remarks at an annual conference for False Claims Act practitioners hosted by the Federal Bar Association.
