Kusserow on Compliance: OIG Special Assistant United States Attorney Program

One interesting note, not widely known, is that the Office of Inspector General (OIG) has a program going back to my days as the Inspector General (IG) to increase enforcement effort efficiency by detailing full-time attorneys to U.S. Attorney Offices where they serve as Special Assistant U.S. Attorneys to support prosecutions. This ad hoc program was later formalized, in 2007, as an ongoing program. Under this arrangement, the Medicare and Medicaid expertise of the OIG is used as a supplement to prosecutors in specialized areas of health care. The OIG 2015 Spring Semi-Annual Report noted the continuation of this program and cited successful cases arising from this arrangement. OIG attorneys are now routinely detailed full-time for a six month period to the Department of Justice’s (DOJ’s) Criminal Division and Fraud Section and also are assigned to the Medicare Fraud Strike Force. Other attorneys prosecute matters on a case-by-case basis, or are employed as Special Agents to the DOJ. This permits the DOJ to have additional program expertise added to their offices, as well as provides experience to the OIG in managing criminal health care fraud investigations. The program also permits OIG attorneys to gain trial experience in federal court with their DOJ Criminal Division colleagues. This collaboration has resulted in a number of successful and important criminal litigated cases relating to the fraudulent billing of medical equipment and supplies, infusion therapy, and physical therapy, as well as other types of Medicare and Medicaid fraud.

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

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Copyright © 2015 Strategic Management Services, LLC. Published with permission.