Less than a week after announcing the largest fraud settlement in U.S. history, HHS' Inspector General June Gibbs Brown announced her resignation and retirement.
Gibbs Brown, 67, will leave her post, which she has held since 1993, on Jan. 3.
Six days before her Dec. 20 announcement, Gibbs Brown along with U.S. Attorney General Janet Reno unveiled the $840 million civil and criminal fraud settlement with HCA -- The Healthcare Co., the nation's largest for-profit hospital chain (Dec. 18-25, 2000, p. 3).
HHS Secretary Donna Shalala said Gibbs Brown left the post at the top of her game and defined the role of inspector general.
"She's an extraordinary public servant and I feel very lucky to have had the opportunity to work with her," Shalala said. "She's a first-rate professional who has strengthened the management of the department and the Medicare program."
During her eight-year stint, Gibbs Brown presided over the most activist time in the agency's history. Collaborating with the U.S. Justice Department in national investigations targeting hospitals, such as the Physicians at Teaching Hospitals, pneumonia diagnosis upcoding, PPS transfer, laboratory unbundling and the DRG 72-hour window programs, the inspector general has generated recoveries of $254.2 million since 1995 alone.
In response to pressure from Congress and the industry, in June 1998 the inspector general's office issued best practice guidelines that set minimum thresholds for when the agency would participate in a national investigation case against a provider. That same day Deputy Attorney General Eric Holder issued guidelines governing how the department invoked the False Claims Act.
As inspector general Gibbs Brown was responsible for auditing HHS' 300 programs, overseeing nearly $400 billion in annual spending and enforcing the laws pertaining to those programs.
In an interview with Modern Healthcare, Gibbs Brown said she was retiring now because of ill health.
"The timing (a change of presidential administrations) is unfortunate," she said. "I don't want to leave the impression that there's a political basis to these jobs. I was appointed twice by a Republican (Reagan), twice by Democrats (Carter and Clinton), and served under Bush as well."
Gibbs Brown said she plans to enjoy life and write a book.
Her career as a civil servant began in 1972. Now a great-grandmother, she raised her four children as a divorced, single mom while working her way through college. She also earned a master's in business administration and a law degree.
She held six inspector general positions for the departments of the Interior and Defense and for NASA before being named HHS' inspector general in 1993 after successfully battling breast cancer.
Brown, a Cleveland native, was a lightning rod for the healthcare industry, which loudly protested the agency's newly aggressive enforcement of the Medicare and Medicaid fraud laws, particularly the use of the False Claims Act against hospitals.
Thomas Scully, president and chief executive officer of the Federation of American Hospitals, said under Gibbs Brown the inspector general's office became far more activist and aggressive than in past administrations.
"I didn't agree with some of the scorched-earth approaches," he said. "I thought they were overly zealous."
The hospital industry lobbied but failed to have the False Claims Act watered down legislatively and through the courts. Gibbs Brown said she wasn't hurt by the strong reaction from the healthcare industry.
"But I was certainly disappointed," she said. "Usually they didn't have the facts and were working on rumor and bits of information. But this was a very new approach and most people hadn't been investigated in the past. I suppose this came as a shock in the community. First we had to get everybody's attention and show that corrective action was needed and that there was oversight in place."
Until President-elect George W. Bush appoints her successor, Gibbs Brown's Principal Deputy Michael Mangano will serve as acting inspector general.