This is the third part in our 2023 series examining important trends in white collar law and investigations. Up next: congressional investigations.

Health care fraud enforcement remained a top priority at both the national and local levels in 2022 and we predict 2023 will be no different. This post details certain categories of health care fraud that regulators and government agencies have indicated will be a focus in this coming year as well as other expected trends. The key takeaways are the following:

Court documents were unsealed this week charging 23 Michigan residents for their alleged involvement in two illegal schemes to defraud Medicare of more than $61.5 million by paying kickbacks and bribes and billing Medicare for unnecessary medical services that were never provided.

Koordinator Advokasi BPJS Watch Timboel Siregar mengungkap sejumlah praktik kecurangan (fraud) yang dilakukan rumah sakit terhadap pasien Jaminan Kesehatan Nasional (JKN), yang menggunakan BPJS Kesehatan. Yakni mulai dari pasien dipulangkan dalam kondisi tidak sadar, hingga diminta membeli obat dan alat kesehatan sendiri.

Badan Pemeriksa Keuangan (BPK) melakukan pemeriksaan atas Laporan Keuangan (LK) Kementerian Kesehatan (Kemenkes) tahun 2022 yang fokus pada enam poin. Pertama adalah pelaksanaan program Penanganan COVID-19 dan Pemulihan Ekonomi Nasional (PC-PEN).