The Growing Role of Data Analytics in Healthcare Enforcement

The US Department of Justice (DOJ) and US Department of Health and Human Services, Office of Inspector General (HHS-OIG) are increasingly relying on sophisticated data analytics tools to identify and investigate fraud schemes, particularly in the healthcare sector. DOJ’s announcement of four new False Claims Act settlements and cases involving similar fraudulent billing schemes further demonstrates the effectiveness and importance of DOJ and HHS-OIG’s data analytics programs. Healthcare companies should take steps to prepare for these data-driven enforcement actions and incorporate data analytics into their own compliance and audit programs.