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Recent Developments in Health Law
The OIG Means Business This Time: The Increasing Use of Strict Liability in Excluding Pharmaceutical Executives from Federal Health Care Programs
Published online by Cambridge University Press: 01 January 2021
Extract
In the past several years, the Office of Inspector General (OIG), the branch of the Department of Health and Human Services that combats fraud and abuse, has begun enforcing a little-used provision that allows the government to exclude owners and managers of sanctioned entities based on their position in the company. The OIG's exclusion authority under 42 USC § 1320a-7(b)(15) is not unique in applying strict liability to individual executives as a tool to halt corporate misconduct, but it represents a startling change for health care executives who could now face exclusion for their company's misdeeds. While the OIG has expanded its use of this statute, it has indicated some hesitancy in exercising the full scope of its statutory power.
Pursuant to §1128 and §1156 of the Social Security Act, the OIG can exclude individuals and entities from participating in federal healthcare programs. The OIG has both mandatory and permissive exclusion power, based on the circumstances of the offense.
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References
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