The following is a summary of the federal Department of Health and Human Services’ Office of Inspector General (OIG) reports of fraud and abuse enforcement activity across the country.[1] The enforcement actions reported are based upon federal and individual states’ activity.

The summaries reflect areas of OIG’s and individual states’ current and recent enforcement activity.[2] Knowing where regulators’ attention is focused can help healthcare providers identify areas of focus for compliance and risk assessment activities. Although not all the enforcement actions may be relevant to any one provider’s healthcare business, there may be some summaries that could be used as examples in compliance program education programs (“What to avoid”), or used in developing a risk management plan. (Note: An Acronym Key appears at the end of the Report.)

Of Note in this Issue:

1. Included for dates prior to July 16^th are OIG’s CIVIL MONETARY PENALITIES AND AFFIRMATIVE EXCLUSIONS REPORT and some late enforcement notices that were published after July 15^th.
2. New Jersey reports on its settlement with the pharmaceutical manufacturer Mallinckrodt. A number of states and the federal government reported their settlement with Mallinckrodt earlier in the year.
3. OIG is pursuing recoveries when visit limits are exceeded - OIG recovered against two different providers for billing for visits that exceeded the allowable visit totals in a rolling twelve-month period.
4. Hospital and Lab CEOs charged with...

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