Government officials told healthcare lawyers last week that the U.S. Justice Department, the FBI and HHS' inspector general's office are resuming their healthcare staffing levels of pre-Sept. 11 and are again focusing on healthcare fraud.
Bush administration political appointees and high-ranking career officials laid out their new federal agenda at last week's American Bar Association annual healthcare fraud conference in San Francisco. And it sounded remarkably like the previous administration's, flavored, of course, by the dramatic detour spurred by the Sept. 11 terrorist attacks.
In a rare public appearance last week, HHS Inspector General Janet Rehnquist told nearly 200 lawyers that the inspector general's office has grown stronger, smarter and more sophisticated in its fraud-enforcement efforts and has adapted to the changing environment in healthcare.
Rehnquist promised that the inspector general's office would focus more attention on quality of care issues, especially in long-term-care settings. She said the office is using sophisticated computers and software programs to analyze data and spot trends and failures to care for nursing home patients. She said her office also will use the federal False Claims Act and is partnering with state Medicaid fraud-control units to go after providers who inadequately staff facilities or fail to provide good nutrition and quality wound care. She vowed that her office would make far greater use of administrative remedies, particularly civil monetary penalties, to punish providers accepting or paying kickbacks. "I think as an enforcement tool, it is currently underutilized," she said.
Lawyers attending the conference said hospitals would face scrutiny on quality of care issues, including several cases under investigation that allege egregious abuse of patients.
Rehnquist said her office would continue its dialogue with healthcare providers and plans a national outreach program centered around a series of open forums to be held at regional inspector general offices beginning this autumn. She said the inspector general's Washington staff would attend the meetings and answer provider questions and explain the office's functions and enforcement positions.
Michael Chertoff, who heads the criminal division of the U.S. Justice Department, said the federal mobilization of resources in the wake of the Sept. 11 terrorist attacks could help the department's antifraud efforts as well. Chertoff said, however, that his office is not looking to play "gotcha" with healthcare providers by unfairly applying criminal sanctions to mistakes and billing errors or testing the extremes of legal definitions.