Fraud and Abuse Control Program and Joint Guidelines Mandated by the Health Insurance Portability and Accountability Act of 1996

The Health Insurance Portability and Accountability Act, signed by the President on August 21, 1996, established and funds a Health Care Fraud and Abuse Program to combat fraud and abuse committed against all health plans, both public and private.

In addition, joint Guidelines issued by the Attorney General and the Secretary of the Department of Health and Human Services to carry out the Fraud and Abuse Program stress the importance of communication and shared information between private and public plans and the federal, state and local governments. The Guidelines also note the importance of parallel or joint proceedings to help maximize the government's recovery while minimizing duplication of effort.

There are restrictions on the derivative use of protected health information. Derivative use must be approved by the Deputy Attorney General. Please see Executive Order 13181,

available at

https://www.gpo.gov/fdsys/pkg/FR-2000-12-26/pdf/00-33004.pdf

. Such requests should go from the USAO to the Deputy Chief for HCF, Criminal Division, Fraud Section.

[updated January 2020]