The Department of Justice is widening its fight against health care fraud beyond Medicare and Medicaid to include corporate misconduct, officials announced this month at the STAT Summit in Boston. Jacob Foster, deputy assistant attorney general for the National Fraud Enforcement division, warned executives not to become "another Theranos," signaling a tougher stance on companies that deceive regulators and taxpayers.

A central piece of the new approach is a streamlined voluntary self-disclosure process. Companies that report potential criminal activity will now have a single entry point at the DOJ, rather than navigating a separate route through the Department of Health and Human Services. In exchange for coming forward, businesses can receive benefits such as a limited cap on financial damages. "There's nothing more that we want to know when a compliance failure occurs than to hear about the great efforts to remediate it, and reward that," Foster said.

The DOJ also plans to lean on data analytics and artificial intelligence to uncover schemes like billing for unneeded services, fabricating patient records, or adding redundant diagnoses. New programs will be designed to "appropriately incentivize" whistleblowers, according to an Oct. 1 memo from Assistant Attorney General Colin M. McDonald. Prosecutors will place extra emphasis on cases involving health care, controlled substances, and violations of the Food, Drug, and Cosmetic Act, and will weigh whether executives knew about or concealed fraud, ran schemes for over three years, or affected taxpayer-funded programs.

Foster framed the effort as a matter of public trust. "No one, irrespective of party, likes the government being ripped off by wrongdoers," he said, noting that such fraud drains Medicare and other trust funds that could run out. The new guidance gives the health care industry a clear incentive to police itself, while putting companies on notice that hidden misconduct will face heightened scrutiny. The article is based on a single STAT report, so no conflicting sources were available for comparison.}markdownjson {