False Claims Act
The U.S. Department of Health and Human Services, Office of Inspector General’s (OIG) Compliance Program Guideline’s identify multiple elements that should be included in an effective Compliance Program to reasonably ensure that the claims submitted to CMS and other federal health care programs are valid and accurate. Healthcare providers who cannot prove that they have taken affirmative and consistent action to eliminate billing errors and to avoid other fraud and abuse complications can be found to have engaged in criminal conduct through deliberate ignorance.