John LeBlanc of Manatt Discusses the Gravity of Healthcare Fraud in the USA As Criminals Gets SmarterSeptember 7, 2021
The COVID-19 related healthcare fraud is dominating the whole of the USA today. These scams are not new, as they did exist before the arrival of the Affordable Care Act and the coronavirus Pandemic. Both state and federal law enforcement authorities in the nation have beefed up their efforts to seek and bring the offenders to justice. They target people guilty of misappropriation of funds from the Provider Relief Fund (PRF) and the Coronavirus Aid, Relief and Economic Security Act, also known as CARES. These incidences of fraud are rising as individuals are starting to take advantage of the situation at every opportunity, including fake vaccination cards and medical supplies that have been counterfeited.
John LeBlanc of Manatt throws an insight into why these healthcare-related frauds are bad for the nation
John LeBlancis a partner with the esteemed national healthcare litigation firm Manatt, Phelps & Philips. Not surprisingly, healthcare providers are involved in corporate fraud. They are able to mimic legal transactions with complicit doctors and other professionals from the healthcare sector who can manipulate or even bypass the internal controls. Corporate fraud from inside the system makes this detection challenging, and the coronavirus pandemic’s advent has actually worsened the problem.
He adds that the COVID-19 Pandemic has detected several weaknesses in the healthcare systems, and sadly, it has been worst hit by fraud. John LeBlanc of Manatt says, “Healthcare fraud was the most significant source of illicit funds in the nation with over $100B in proceeds and accounted for more than 35 percent of all illegal proceeds laundered in the United States.”
He goes on to say, “Currently, Medicare processes more than 4.5 million claims a day. A likely target of increased governmental focus is those who received the Provider Relief Fund funds created as part of the more expansive Coronavirus Aid, Relief, and Economic Security Act.”
Counterfeit claims are on the increase
Besides the above cases of fraud, government relief programs like PRF, there are episodes of counterfeit claims that are increasing. They include fake vaccines, medical supplies, and a rise in fraudulent vaccination records. These counterfeit items are a dangerous threat to the overall safety and health of the public, especially with concerns revolving around the different variants of the coronavirus that are currently on an all-time high.
He says there are reports of counterfeit vaccines related to the coronavirus that is being distributed in Poland and Mexico (Pfizer).
John LeBlanc of Manatt cautions that the above practice will worsen as these vaccines are being rolled out in socio-economic nations as booster shots are increasing. Counterfeit vaccine cards are a growing concern as hesitancy and further government mandates are dominating the workforce and the educational institutes in the nation. As businesses are making plans for a return to work and schools across the USA are emerging from virtual education, detecting and removing these counterfeit medical supplies from healthcare facilities and hospitals is critical to effectively reduce the transmission of COVID-19 and other infectious diseases in these areas.