Matthew Krueger Assesses Government Health Care Enforcement Focuses for 2025

Foley & Lardner LLP partner Matthew Krueger assessed several key government health care enforcement targets for the year ahead in the Report on Medicare Compliance article, “Outlook 2025: Look for MA Cases Based on Claim Denials; Incoming DOJ May Tweak Guidance,” published by the Health Care Compliance Association.

“We will continue to see robust enforcement under a new [U.S. Department of Justice] even if its main priority will be in other areas, such as violent crime, immigration, and drug trafficking,” Krueger explained, noting too that some enforcement and compliance guidance released under the Biden administration may be revisited this year.

Krueger highlighted DOJ’s Criminal Division’s guidance on voluntary disclosure and cooperation credit as an example. “We could expect a more pragmatic approach to what counts as cooperation credit,” he commented, adding historical context on the individual accountability policy introduced under the Obama administration.

“It was modified by the Trump administration to allow a more flexible approach to assessing cooperation,” Krueger said, with the Biden administration shifting its direction back closer to how it was originally implemented. “We may see the pendulum swing back again,” Krueger continued, emphasizing that he also hopes the DOJ will go on to spell out the rewards for cooperation credit on the civil side as it does on the criminal side.

Another change Krueger expects under the new administration is an adjustment to the Evaluation of Corporate Compliance Programs.

“The changes may be more around the margins,” Krueger noted, because both Trump administrations “see value in providing guidance to the regulated community.”