Physicians (and other Providers) Beware! OIG Announces New Enforcement Team Focused on CMPs and Exclusion

Last week, at the annual meeting of the American Health Lawyers Association in Washington, DC, the U.S. Department of Health and Human Services Office of Inspector General (OIG) announced the creation of a new litigation team focused solely on using the OIG’s authority to impose civil monetary penalties and exclude individuals and businesses from Medicare and Medicaid.

Located within the Office of Counsel to the Inspector General (OCIG), the unit debuted in March and is expected to have 10 attorneys when fully up and running. In addition to providing a new enforcement resource, this new OIG focus creates additional potential exposure for individuals and entities doing business in the health care industry, particularly because the OIG can impose many of these sanctions based solely on its own discretion.  
 
At a session attended by Arent Fox attorneys, OCIG attorneys Robert Penezic, the OIG deputy branch chief in charge of the new team, and Lisa Re, chief of the OIG’s administrative and civil remedies branch, described the new team as being formed with the goal of increasing the focus on individual providers who perpetuate fraud and abuse that puts patients at risk of harm as the result of tainted medical judgment. Because kickbacks will be a primary area of enforcement, physicians likely will be in the crosshairs. This focus on enforcement against physicians ties in with the OIG’s recent publication of a new Fraud Alert, which we previously analyzed here.
 
Overall, the new OIG team seeks to fill enforcement gaps by pursuing cases that would otherwise go unaddressed due to a lack of DOJ resources. In addition, the team plans to pursue cases identified by other units within the OIG, including the Office of Audit Services and the Office of Evaluation and Inspections. The unit also will pursue cases identified by monitoring entities operating under Corporate Integrity Agreements.

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