HHS Wields Checkbook To Pressure State Fraud Units

Kate Driscoll spoke to Law360 about the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) denying recertification of New York and Hawaii's Medicaid Fraud Control Units and suspending federal funding to the states. She opined the impacts of this move may reach beyond New York and Hawaii, stating she expects "units across the country to rebalance toward generating higher counts of criminal indictments and convictions — even where that means pursuing smaller, lower-dollar cases — to satisfy the federal performance metrics OIG is now actively scrutinizing."

She added, "With OIG now pressing states to produce higher criminal indictment and conviction counts, providers should expect more investigations opened, faster referrals to prosecutors, and increased documentation scrutiny."

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