The HHS Office of Inspector General (OIG) issued its Semi-Annual Report for first half of fiscal year (FY) 2016 (October 2015 to March 2016) and summarizes key accomplishments, significant problems, abuses, deficiencies, and investigative outcomes relating to the administration of HHS programs and operations that were disclosed during the reporting period. Included in this report is a section referred to as the “Special Assistant U.S. Attorney Program.” What this refers to is the fact that the Department of Justice (DOJ) frequently cross-designates OIG attorneys to assist in health care fraud prosecutions. Under this program, the OIG participates in a program in which OIG attorneys, some of whom are special agents, serve as Special Assistant U.S. Attorneys. These OIG attorneys are detailed full time to the DOJ’s Criminal Division, Fraud Section, or a U.S. Attorney’s Office, for temporary assignment, including assignment to the Health Care Fraud Strike Force. Some of the attorneys are called upon to prosecute matters on a case-by-case basis. Under this program, OIG attorneys have successfully litigated important criminal 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.
Tom Herrmann, who served in the Office of Counsel to the Inspector General for 20 years, explained that this is a practice that goes back decades. In the early days of criminal and civil enforcement of health care fraud cases, there was a shortage of attorneys in the DOJ who were experienced in such matters. The OIG lent some of its attorneys to add health care knowledge and expertise to the DOJ. When doing so, the OIG attorneys were cross-designated as Special Assistant U.S. Attorneys. This practice has flourished over the years and has been beneficial to both the DOJ and OIG. The DOJ is supplemented with health care experts as needed and the OIG attorneys are provided top-notch litigation training. The public benefits from this enhanced collaboration in the fighting health care fraud. What this means is that in an area of the country where the local U.S. Attorney’s office may be weak on health care enforcement, they have the OIG available to supplement and reinforce them.
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 © 2016 Strategic Management Services, LLC. Published with permission.