Among the abundance of opportunity for potentially lucrative investments in the healthcare industry lie hidden risks that could cause monetary loss and reputational damage. As part of a recent due diligence investigation, Vcheck Global’s highly skilled investigators identified significant risks associated with a possible medical practice investment and put them into context for the client.
The client contacted Vcheck Global about a possible investment into a medical practice based in the U.S. Vcheck Global investigators discovered in public records that the medical practice had been fined several times by the U.S. Department of Justice for violations of laws regarding Medicare fraud and participation in kickback schemes.
These risks are more common than one might think. The Justice Department’s recoveries from lawsuits involving healthcare fraud have steadily increased over the past several years, indicating both the priority the federal government places on deterring such fraud as well as the potential growth in healthcare fraud. The department recovered $2.1 billion from healthcare fraud lawsuits in 2017, $2.5 billion in 2018, and more than $2.6 billion in 2019, according to federal data released in January 2020. On top of these recoveries of federal losses, the department has also recovered millions from fraud associated with state Medicaid programs.
Based on the discovery of Medicare fraud and kickback schemes associated with the potential investment opportunity, Vcheck Global undertook source inquiries upon consultation with the client to ascertain how this issue has impacted the reputation of the company and its partner. Human source intelligence involves conducting source inquiries within an industry to identify risks, convey their significance, and contextualize the potential long-term implications of those risks.
Upon utilizing Vcheck Global’s human-source intelligence investigative capabilities, Vcheck Global found that these issues led to a “questionable” industry reputation for the medical practice and that involvement in multiple of these schemes was a “pattern of behavior.” The final report Vcheck Global produced for the client was able to put what was found in public records into greater context of industry reputation and how the company and its founder were viewed by peers.