If you read this blog with any regularity (or even if you read healthcare related news from time to time), you should be aware of the emphasis that federal and state enforcement authorities are placing on healthcare fraud and abuse enforcement. Despite these intensive fraud and abuse enforcement activities, however, many physicians and healthcare providers are still not devoting meaningful resources to compliance planning. I suspect that one of the main reasons for this is the fact that most physicians do not feel as though they have the economic or manpower resources to devote to compliance. I suspect as well, however, that many physicians simply do not appreciate the seriousness or implications of a fraud investigation/action.
The Office of Inspector Gen. (OIG) of the Department of Health and Human Services has published on its website a document which offers an intriguing glimpse into the process the OIG follows when investigating and prosecuting a fraud action. Specifically, the OIG has published testimony given by Daniel R. Levinson, the Inspector General, in a hearing today before the U.S. Senate Committee on Finance in which he describes the anatomy of a fraud action from investigation to conviction. Those interested in maintaining fraud and abuse compliance and understanding the process will find this to be very worthwhile reading.