OIG-HHS issues call for quality-of-care monitors

by bvernia | October 17th, 2009

In a notice issued in the Federal Register, the OIG-HHS solicited monitors for quality-of-care Corporate Integrity Agreements (CIAs). The OIG’s notice should not be confused with a request for proposal, it states:

The Office of Inspector General (OIG) is seeking to identify potential organizations to monitor health care entities under quality-of-care Corporate Integrity Agreements (CIA) with OIG. OIG is interested in receiving information from organizations that believe they have the capability to be monitors for quality-of-care CIAs.This is not a request for proposals and does not commit OIG to select or consider a particular organization to be a monitor. Any information provided to OIG in response to this notice is strictly voluntary. The Government will not pay for information submitted in response to this notice.

The OIG’s notice does its best to downplay the significance of its request. Recent settlements, however — such as the Willowcrest case in the Philadelphia, whose US Attorney’s office has taken the lead in quality-of-care suits and settlements– suggest that OIG and DOJ are still feeling their way in this relatively new area. The Willowcrest civil settlement agreement contains many compliance provisions which have long been the province of separate CIAs negotiated and signed by the OIG – suggesting some uncertainty within the OIG regarding how to deal with these cases. In addition, the use of a monitor in these cases differs from garden-variety Medicare, pharmaceutical, and other fraud cases, which typically require Independent Review Organizations with much narrower responsibilities. It remains to be seen whether the monitor model becomes more prevalent in health care settlements generally, or is restricted to quality-of-care cases.

Leave a Reply

Recent Posts

Recent Comments