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Florida Healthcare Law Firm
The U.S. Department of Health and Human Services Office of Inspector General (OIG), has produced literature regarding their intention to prosecute private equity firms who do not conduct proper due diligence in healthcare deals. At this time, a few private equity firms have been charged in civil litigation cases for healthcare fraud related civil allegations. However, the OIG has stated that healthcare laws with criminal penalties are not off the table. How does this impact deal flow? Knowing who now stands over the shoulder of private equity, venture capital, family offices (“PE Groups”) is essential, because it dictates what they will have to look for in acquisitions to come.
Compliance with billing and coding practices should be at the top of the list for PE Groups conducting a sort of regulatory due diligence. Medicare Advantage has become an area of concern as well, as the government is aware and realizes that there is opportunity for improper billing under Medicare Advantage coding and billing procedures, also known as MRA gaming.
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