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New OIG Litigation Team To Focus on Fines, Exclusions from Federal Programs

At the American Health Lawyers Association annual meeting this past week, the Department of Health and Human Service’s Office of the Inspector General announced the implementation of an OIG Litigation Team which will focus on Civil Money Penalties and Exclusions. The unit will specialize in assessing civil penalties and excluding providers, drug manufacturers, and others participating in fraudulent schemes, such as kickback and overbilling arrangements.

Because the unit will devote its time specifically to these cases, the OIG believes it will be able to better target and identify these fraudulent arrangements, which will in turn lead to greater enforcement and therefore more penalties and exclusions from Federal programs. The aim is to curb both unfair competitive advantages due to fraud and interferences with providers’ medical judgment.

To illustrate the variety of cases the team will focus on, the OIG’s presentation included examples of previous penalties and exclusions assessed by the OIG. These included the $12.6 million penalty against a company for drug price reporting; a $5 million settlement with a laboratory company for urine-test fraud, and a $1.5 million penalty and 15-year exclusion for a medical doctor accused of fraud.

While the OIG will not specifically target individual providers any more so than larger companies, it may be more difficult for individual providers to avoid the OIG’s increased scrutiny because larger companies have more resources to properly implement compliance standards for some of the more complex regulations.

This new litigation team has been in the works for some time, however, it was not implemented until this March because of budget constraints.

Health care providers dealing facing OIG or regulatory scrutiny of any kind should speak immediately with the health care fraud lawyers at Buttaci Leardi & Werner, LLC.

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  • Posted on: Jul 1 2015