OIG Adds New Litigation Unit Focused on Fines and Exclusions

Mintz - Health Care Viewpoints

On June 30, 2015, the Department of Health and Human Services’ Office of Inspector General (OIG) announced that it would be staffing a new specialty litigation unit whose sole focus will be on levying civil monetary penalties (CMPs) and excluding individuals and entities from participation in Medicare and Medicaid. The litigation unit will be comprised of approximately 10 attorneys when hiring is complete. The announcement came at the annual meeting of the American Health Lawyers Association (AHLA) in Washington, D.C.

The concept of an OIG unit dedicated to CMPs and exclusions is not new, but was apparently delayed due to budgetary constraints. That the OIG’s budgetary constraints have lessened is not surprising: in a 2015 report, the OIG reported an $8 to $1 return on investment for the Health Care Fraud and Abuse Control Program, to which OIG is a key partner.

Robert M. Penezic, an OIG deputy branch chief in charge of the new team, and a presenter at the AHLA conference, predicts that the new unit will lead to an increase in enforcement.

The OIG also tweeted the announcement. Interestingly, it linked not to a press release discussing the new team but rather to its June 9, 2015, fraud alert that outlined the OIG’s growing concern over an increase in fraudulent physician arrangements:

The OIG’s increased enforcement efforts against physicians and others receiving kickbacks was echoed by Lisa Re, chief of the OIG’s administrative and civil remedies branch who was a co-presenter with Mr. Penezic at the AHLA conference. “What you’re going to see are a lot of kickback cases, both against the payor of the kickbacks…and the recipient of the kickbacks, which tend to be physicians,” Ms. Re said in an interview with Law360.

This development comes on the heels of an announcement by the Medicare Fraud Strike Force of its most significant take down to date, charging 243 individuals for approximately $712 million in alleged Medicare fraud.

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