Affordable Care Act Fraud Provisions (2010)

Beyond expanding coverage, the Affordable Care Act (ACA) reshaped healthcare fraud enforcement. At Barrett Johnston, we see its fraud provisions as some of the most impactful reforms in modern healthcare law.

The ACA strengthened the False Claims Act (FCA) and the Anti-Kickback Statute (AKS), clarifying that any claim tainted by a kickback is automatically a false claim. It also lowered the intent threshold for AKS violations, making it easier to prove wrongdoing.

Additionally, the ACA expanded the authority of the Centers for Medicare & Medicaid Services (CMS) and the Department of Justice (DOJ) to conduct audits and data-driven investigations, and also expanded the scope of protected conduct covered by the FCA’s anti-retaliation provisions.

For whistleblowers, the ACA reinforced a national message: fraud against healthcare programs undermines public trust — and those who expose it deserve strong protection.