- Price is Out, But Health Care Fraud and Compliance Enforcement Remain Steady
- November 9, 2017 | Authors: Anne M. Tompkins; Stephen Weiss
- Law Firms: Cadwalader, Wickersham & Taft LLP - Charlotte Office; Cadwalader, Wickersham & Taft LLP - Washington Office
Tom Price is out as Secretary of the U.S. Department of Health and Human Services (“HHS”). Mr. Price announced his resignation on September 29th as he faced more questions and increasing scrutiny over his use of taxpayer-funded private planes. While Mr. Price’s departure from HHS will impact some aspects of the Trump Administration’s health care agenda, health care enforcement and compliance issues are bi-partisan in support and therefore less volatile.
Under Inspector General Daniel Levinson, who has led HHS’ Office of Inspector General (“OIG”) for twelve years, HHS remains committed to detecting, preventing, and prosecuting individuals and companies for health care fraud.
Accordingly, all signs point to OIG continuing to focus on detecting fraudulent billing practices and illegal physician referral programs, and using corporate integrity agreements to ensure that health care providers obey Medicare and
Medicaid rules and policies.
In addition to fighting fraud in HHS programs, Health Information Portability and Accountability Act (“HIPAA”) security and cyber security are top priorities for HHS’ Office for Civil Rights (“OCR”). To combat cyber security threats and to mitigate damage caused by cyber security breaches, OCR will likely increase its enforcement of HIPAA privacy rules and regulations and scrutinize providers’ cyber security policies, best practices, and response procedures. Driving home this point, new OCR Director Roger Severino said, “I’ve gotten up to speed on HIPAA, and as the threats evolve, we have to evolve in how we approach it – and we have to be smart about who we target. At most I will say the big, juicy case is going to be my priority and the methods for us finding it – stay tuned.” 
Under Attorney General Jeff Sessions, the U.S. Department of Justice has maintained a high tempo in its efforts to combat health care fraud. For example, in July 2017 DOJ announced a partnership between its Health Care Fraud
Unit’s Corporate Fraud Strike Force and Foreign Corrupt Practices Act (“FCPA”) prosecutors to ensure that health care companies are held accountable to the standards of the False Claims Act and the FCPA. And DOJ’s new Opioid Fraud and Abuse Detection Unit will help combat the ongoing opioid crisis, in keeping with Attorney General Sessions’ enforcement priorities.
Tom Price’s departure as HHS Secretary is significant for other important aspects of health care, including the future of the Affordable Care Act and the Medicare and Medicaid bundled payment models. However, current HHS and DOJ enforcement programs remain a priority under President Trump and Attorney General Sessions.
Marianne K. McGee, Top HIPAA Enforcer Names His Top Enforcement Priority, Data Breach Today (Sept. 5, 2017), https://www.databreachtoday.com/top-hipaa-enforcer-names-his-top-enforcement-priority-a-10258.