OIG launches fraud team to target physicians, healthcare executives

The dedicated litigation team will focus on the smaller entities such as individual physicians and executives in civil penalties and exclusion cases.

A new civil litigation team to combat fraud will focus on individual physicians and provider executives, federal officials announced Tuesday.

“I think what it does is give the OIG more resources to enforce the authority that it has,” said Tony Maida, a former deputy chief in the Office of Counsel to the Inspector General.

The dedicated litigation team will focus on the smaller entities such as individual physicians and executives in civil penalties and exclusion cases.

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The Department of Justice tends to focus on those with deep pockets, but OIG’s administrative cases are smaller in size in terms of dollars and the type of target.

Healthcare providers who are doing the right thing suffer from others who are abusing the system, Maida said because they are put at a competitive disadvantage.

“It hurts business if you’re taking a more conservative approach,” Maida said.

The team of 10 to 12 lawyers will have the sole job to investigate and litigate OIG cases. Currently the OIG has is a group of lawyers who wear multiple hats.

The names of the attorneys on the civil litigation team were not made public during the announcement at the American Health Lawyers Association conference by OIG officials Lisa Re and Robert Penezic.

The plan has always been to create such a team, one that could dedicate 100 percent of its day to pursuing cases, but due to budget restraints, the plan never got off the ground, according to Maida.

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This year, Congress increased appropriations to control fraud.

Maida worked for OIG for ten years until January. He is now a partner at international law firm McDermott Will & Emery in New York.

“By adding resources, the government is able to take a more holistic approach to each case,” Maida said. “What we see is a big increase in the number of cases the OIG has gotten.”

Twitter: @SusanMorseHFN