Every year, the Department of Health and Human Services Office of Inspector General (HHS-OIG) releases its Fiscal Work Plan, outlining its expected oversight work involving hospitals, nursing homes, home health services, medical equipment and the government health insurance marketplaces, pointing to, inter alia, concern about Medicare fraud in certain specified health care services or products.
While it is easy to dismiss this work product as just another bureaucratic tomb, it is, in actuality, an invaluable resource that reveals the government’s primary fraud concerns with government healthcare programs. For example, Fiscal 2014 Work Plan states that HHS-OIG will scrutinize Medicare claims to identify the costs resulting from additional utilization of medical services associated with defective medical devices. This type of conduct is actionable under the False Claims Act if the manufacturer knowingly or recklessly produces the defective medical devices, showing disregard for patient health and safety.