Melissa L. Jampol and Jennifer E. Michael, Members of the Firm in the Health Care & Life Sciences practice, in the firm’s New York and Washington, DC, offices, were quoted in Healthcare Risk Management, in “DOJ, OIG Changing Enforcement Policies for COVID-19 Era,” by Greg Freeman.
Following is an excerpt:
The federal government’s fraud and abuse enforcement priorities are shifting in response to COVID-19. Risk managers should be ready to adapt their compliance programs in response to the changing risks.
Federal authorities are prioritizing resources to focus on COVID-19-related issues, says Melissa L. Jampol, JD, an attorney with Epstein Becker Green in New York City. This new focus includes everything from personal protective equipment (PPE) scams, identity theft, and tax issues.
“Right now, they are focusing on low hanging fruit, such as the Paycheck Protection Plan going awry and somebody buying a Lamborghini,” Jampol says. “But the enforcement efforts are going to go on for many years from now, in much the way we saw continuing enforcement after the 2008 financial crisis.”
High Alert for Fraud
There will be an evolution of enforcement activities, says Jennifer E. Michael, JD, an attorney with Epstein Becker Green in Washington, DC, who previously worked with the Department of Health and Human Services Office of Inspector General (OIG). Prosecutors will be looking for relatively easily discovered crimes, like submitting lists of employees who do not actually work for the organization to receive more aid.
“There tends to be a lag in enforcement because the bad thing has to happen, then government has to learn that the bad thing happened through qui tam suits, data analytics, audits, or a variety of ways,” Michael says. “Everyone is on high alert because there is so much money flowing so quickly. At the same time, OIG issued a message from leadership on minimizing burdens on providers, so OIG recognizes that right now there is a lot of confusion about what’s okay.”
Michael says there is some reasonable confusion about what is allowed, what is questionable, and what is outright fraud. OIG has issued guidance stating that it is balancing those concerns while continuing with its mission to prevent fraud and misuse of funds.
“OIG is first going to make sure that the beneficiaries are not being harmed, but second that the federal resources aren’t being pillaged,” Michael says. “I think OIG will be cognizant of the need to investigate and pursue enforcement against things that aren’t so egregious but are still fraudulent, for the deterrent effect. It’s important to focus on compliance, and once the dust settles, to go back and look at how you expended your CARES [Coronavirus Aid, Relief, and Economic Security] Act funds.”