Bass, Berry & Sims attorney Matt Curley was quoted in an article for the Report on Medicare Compliance that examined a growing trend among major healthcare organizations declining corporate integrity agreements (CIAs) in favor of placement on the Department of Health and Human Services Office of Inspector General’s (HHS-OIG) “heightened scrutiny” list following False Claims Act settlements. Entities are opting for this path, reflecting a shift in how organizations assess regulatory risk relative to the cost and operational burden associated with CIAs.
Matt explained that the deterrent effect of the list appears to be diminishing, observing that “the initial effect of the threat of being placed on the heightened scrutiny list” is wearing off. He noted that organizations are increasingly “making the calculation that the cost and burden of a CIA outweigh any downside,” and that he has not observed “any noticeable repercussions.”
The trend raises questions about how OIG may respond and whether the heightened scrutiny framework is sustainable. While regulators could increase oversight if more entities refuse CIAs, Matt pointed to potential legal vulnerabilities, warning of “due-process concerns” with publicly designating organizations as high risk without a clear avenue for review.
The full article, “More High-Profile Entities Refuse CIA, Accept ‘Heightened Scrutiny’” was published in the May 4 edition of the Report on Medicare Compliance newsletter, a publication of the Health Care Compliance Association (subscription required).