Lauren Briggerman Discusses Heightened Compliance Risks in Healthcare Risk Management
Subtitle
"Staying Compliant Can Be Challenging in 2025"
Healthcare Risk Management
Lauren Briggerman highlights federal enforcers’ renewed commitment to rooting out fraud in the health care sector, emphasizing their focus on data analytics and third-party vendor oversight. "Companies and providers need to be extremely vigilant in particular of the third-party vendors they may use for software for billing," she says, stressing the importance of proper due diligence. She also points to the formation of the Department of Justice-Health and Human Services (DOJ-HHS) False Claims Act (FCA) Working Group as a sign of more coordinated and aggressive investigations, noting, "You're going to see more streamlined investigations. And probably bigger dollar resolutions." With billion-dollar verdicts like the Johnson & Johnson case, Briggerman anticipates legal challenges to the qui tam provisions of the FCA, which could significantly impact the government's ability to pursue fraud cases. Healthcare risk managers should stay alert and reassess their compliance strategies in light of these developments.