Sneak Preview: HHS OIG Proposes Monetary Penalties for Grant Fraud
(The following was excerpted from a recent article in the Federal Grants Management Handbook.) The Department of Health and Human Services (HHS) Office of Inspector General (OIG) recently proposed to amend agency regulations to activate an authority under the 21st Century Cures Act (Pub. L. 114-255) to assess civil money penalties (CMPs) and program exclusions for those recipients who engage in fraud and misconduct under an HHS grant, contract or agreement.
OIG is accepting comments on the proposed rule through June 23, and comments may be submitted to Regulations.gov by referring to “HHS_FRDOC_0001-0758.” OIG will monitor requests to extend the comment period due to the COVID-19 public health emergency.
The CMP assessment for grants, contracts and agreements is only one of the provisions in the proposed rule. It would also establish new CMP authorities for information blocking (i.e., any practice that is likely to interfere with, prevent or materially discourage access, exchange or use of electronic health information) and increased maximum penalties for certain CMP violations.
The Civil Monetary Penalties Law (CMPL) (42 U.S.C. 1320a-7a) currently authorizes HHS to impose civil money penalties and/or exclude from the Medicare and Medicaid programs physicians who commit various forms of fraud and abuse involving Medicare and Medicaid. The proposed rule would modify HHS regulations at 42 C.F.R. parts 1003 and 1005 to add HHS’ new authority under the Cures Act related to fraud and other misconduct involving grants, contracts and other agreements into the agency’s existing regulatory framework for the imposition and appeal of CMPs, assessments and exclusions.
The modified regulations would: (1) expressly enumerate in the regulation the agency’s grant, contract and other agreement fraud and misconduct CMPL authority; and (2) give individuals and entities sanctioned for fraud and other misconduct related to HHS grants, contracts and other agreements the same procedural and appeal rights that currently exist for those sanctioned for fraud and other misconduct related to federal health care claims under the CMPL.
(The full version of this story has now been made available to all for a limited time here.)
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