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Home » Maine, New Hampshire, & Vermont Remain DOJ Health Care Enforcement Priorities: Targeted Federal Enforcement Presents Serious Risk | Verrill
The United States Department of Justice (DOJ) recently emphasized that Maine, New Hampshire and Vermont have priorities for health care investigations and expect significant enforcement. Even well-run (and law-abiding) organizations and law-abiding practitioners may be responsive to government investigators and should always tread carefully when the government comes knocking.
Enforcement will focus on opioid misprescribing, but will be broad and could include investigations into allegations of healthcare fraud, suspected overcharging, allegations of non-provision or under-provisioning of services and telemedicine. The DOJ will also increase its scrutiny of clinical laboratories, nursing homes, compliance programs and adherence to Drug Enforcement Administration (DEA) diversion protocols. It is critical to consult with experienced government prosecution attorneys like Verrill’s with any government involvement.
At the September 2022 American Health Lawyers Association conference in Baltimore, Maryland, DOJ Assistant Attorney General (AAG) Kenneth A. Polite, Jr. announced the DOJ’s newest strike force focused on northern New England and announced that the DOJ is already anticipating significant enforcement activity in the region. Nationally, AAG Polite oversees a team of over 600 prosecutors, more than 80 of whom focus on healthcare fraud and related investigations. AAG Polite’s focus on Northern New England as the top DOJ priority is insightful and demonstrates just how serious the DOJ is about taking action in the region. AAG Polite cited telemedicine, interstate prescription of opioid drugs, and pharmaceutical wholesalers and distributors as specific areas of DOJ interest. Noting the need for robust compliance programs, AAG Polite noted that the DOJ’s newly installed chief of healthcare fraud is a former chief compliance officer. The AAG also strongly encouraged all healthcare organizations to ensure they have adequate staff to review their own data and act on observations when necessary. At the same conference, the Honorable Christi A. Grimm, Inspector General for the Department of Health and Human Services (HHS OIG), reported that nursing homes are among the top priorities for her organization, which often works hand-in-hand with the DOJ.
In a June 2022 alert, Verrill reported that the DOJ had assembled a task force called the New England Prescription Opioid Strike Force (NEPO). According to the DOJ, NEPO’s job is to track the data and track any possible diversion of controlled substances, including opioids. The DOJ will likely review the claim dates and prescription documents to flag issues for further investigation. Hospital systems, clinical laboratories, healthcare practice groups, and physicians would be wise to monitor and review their own data — looking for trends, spikes, and outliers — since the DOJ is likely already reviewing that data.
The DOJ has compared the newly formed NEPO to the Appalachian Regional Prescription Opioid Strike Force (ARPO), which remains the government’s most successful regional task force and recently celebrated its fifth anniversary. ARPO’s first enforcement action took place approximately six months after its formation, when ARPO charged 60 people, including 53 medical professionals, with a range of criminal offences. In conjunction with law enforcement, ARPO also worked to bar providers from participating in Medicare, Medicaid, and all other government healthcare programs. The DEA issued several stay orders, justification orders, and received voluntary surrenders of controlled substance registrations. Since its inception in 2018, ARPO has conducted takedowns approximately every six months, which have led to numerous criminal charges, administrative proceedings and civil settlements.
Many, but not all, Justice Department enforcement actions target bad actors involved in willful misconduct — not law-abiding systems, providers, or practitioners. Still, the DOJ and its task forces cast a wide net, and even law-abiding corporate citizens and practitioners can interact with NEPO and respond to investigations or inquiries. While seemingly harmless, any interaction with the government should be carefully considered and handled in consultation with experienced enforcement lawyers.
snack: The DOJ and its task forces cast a wide net. Even the most law-abiding organizations and individuals can experience interactions with government enforcement and should always proceed with caution. The DOJ actively reviews historical and likely real-time claims data and prescribing records for physicians of all types in Maine, New Hampshire and Vermont. Review your own data – look for trends, spikes and outliers. Examine the results to identify potential problems and determine appropriate actions if necessary. Think carefully and quickly about how to deal with overpayments or suspected overpayments. Investigate complaints from whistleblowers or employee hotlines and document your findings. If necessary, consider hiring outside counsel to investigate allegations. Service providers, individuals or entities contacted should consult experienced enforcement attorneys.
Tags: Care, DOJ, Enforcement, federal, Hampshire, health, Maine, Presents, priorities, Remain, Risk, targeted, Vermont, Verrill Continue Reading