OIG stands for the Office of Inspector General. The office is part of the Department of Health and Human Services in the United States. The role of the office is to oversee all the activities relating to health care service providers’ engagement in Medicaid and Medicare programs. You must take action immediately you receive a subpoena from the OIG to avoid criminal or civil fines.
If you are in America and you offer health care services, you are under the directives of the government. Unfortunately, the Medicaid and Medicare programs face high charges yearly due to the nation’s healthcare fraudulent activities. However, the OIG, together with other federal service providers, can evaluate the data and know the providers who practice fraudulent activities without many struggles. As a result, all healthcare sectors in the country face investigations and audits more frequently.
If you’ve been sent an OIG subpoena, you must understand the details well, whether it is for business or practice. Also, it would help if you gave the feedback to the subpoena properly to avoid further investigations and criminal prosecution.
For these reasons, we offer help to our clients so that they can avoid mistakes that would be costly and cover the clients from OIG inspections.
As highlighted before, the OIG is an authoritative house dealing with health and human life whose main purpose is to govern the integrity of HHS programs. It is a significant organization within the federal government.
The organization inspects and impose fines on healthcare providers who are engaged in fraudulent activities in the health care sectors. The OIG works hand in hand with CMS- Centers for Medicare and Medicaid Services, FBI- Federal Bureau of Investigations, and DEA-Drug Enforcement Administration. All the agencies collaborate to find all the service providers who take part in the fraud.
Reasons for Inspecting Healthcare Service Providers
When the OIG decides to inspect the healthcare service provider, either the healthcare service providers are suspected or believed to take part in fraud involving healthcare programs. The OIG inspects the healthcare sector due to:
When the billing data shows a big difference from other service providers, then it implies that the information provided is wrong. That is when an OIG starts investigating. While investigating, the OIG operates under subpoena powers to analyze if there are enough reasons to impose criminal or civil fines.
When the OIG conducts an inspection, they use subpoena powers. In this case, the subpoena refers to an official request for data or documents issued by OIG. The Federal law gives powers to the OIG to issue a subpoena for healthcare service providers for inspection without having to pass through the superior offices.
What happens when you receive an OIG?
When you get a subpoena, it doesn’t imply that you are being charged for a crime. Instead, it implies that the OIG wants to conduct some research into the Medicare billing of your services. An investigation doesn’t guarantee that you will face charges. However, at this point, you need to focus on preventing the government from imposing charges on you.
Our services have worked for many service providers to go through the inspection process without facing any fines. However, we understand that cases are different, so what worked for someone else might not work for you, according to the matter at hand.
Note: The OIG inspection can be in the form of a criminal or civil offense. Once you get in touch with our services, we, first of all, evaluate the nature of your case. If the case revolves around civil offense, we ensure the whole process remains civil.
Is there a need to respond to the OIG’s Subpoena?
The best way to approach the matter is by giving the required feedback. It doesn’t matter whether you have evidence to challenge the subpoena or if you need more time to figure out what next. Respond within the specified time frame to avoid more complications.
When representing our clients who have received an OIG subpoena, our lawyer for healthcare fraud activities work hand in hand with the attorney from OIG to ensure they receive only the relevant information.
There are instances where the OIG subpoenas request unnecessary documents such as marketing materials, corporate data, legal opinions, billing records, and emails, financial statements. It is our responsibility to ensure our clients don’t disclose more than enough to the OIG’s during the investigation. We analyze the required documents to ensure they comply with the subpoena requirements.
If I withhold some information either intentionally or unknowingly, what will happen?
It is hard to know whether the information complies with the OIG subpoena requests. However, if it complies with the OIG’s subpoena requests, then you must provide the information required to avoid extra charges. However, if you didn’t know the information was needed, you can always address the matter as soon as possible.
What happens if the OIG gets the Evidence of Fraudulent or a fault in billing records?
Supposed the OIG get the evidence that you are involved in fraud, you can request for further inspection of your business. The trend can continue until the OIG finds enough evidence to proceed with criminal or civil fines.
What happens when I am found liable to Fraudulent?
When the OIG continues with the fines, the fines will depend on the allegations placed against you and the laws involved. However, in civil matters, the service provider found liable can face incarceration, penalties, or both. As for criminal charges, it can include substantial financial fines or many years behind bars.
What other penalties can one face after OIG inspection?
Apart from criminal and civil fines, healthcare providers risk losing their working licenses. In extreme cases, the OIG can impose the need to inspect the internal compliance requirements of your business.
Are there Defenses to OIG subpoena and Healthcare Fraud Charges?
As highlighted before, the charges and fines differ from one case to another. This implies that the defense is there, but according to the magnitude of the matter at hand. However, there must be thorough inspection, and the government must produce concrete evidence before imposing the fines.
About Spodek Law Group
Our firm has a team of experts specialized in handling defense cases against healthcare service providers Fraudulent activities. We have a team of expert attorneys who understand all the requirements when it comes to healthcare service providers matters.
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