Office of the Medicaid Inspector General – OMIG
One of the agencies that not a lot of people are aware of is the OMIG, also known as the Office of the Medicaid Inspector General. This office is specifically tasked with staging audits of healthcare providers and recipients, looking for irregularities and violations, and then investigating and prosecuting based on what they find. While these agencies conduct investigations on their own, they typically coordinate with other law enforcement agencies and authorities to prosecute those they find in violation.
It’s vitally important that anyone facing legal trouble when it comes to the Office of Medicaid Inspector General secure competent legal counsel immediately. Whether you’re a healthcare provider or recipient, you’re at risk whenever you find yourself under investigation by the OMIG. The best thing you can do is to hire a defense lawyer before anything else. But the problem here is that there are just so many law firms out there. You need one that has the experience, skills, and resources necessary to take on the OMIG and win your case. You need the Norman Spencer Law Group.
What is the OMIG?
The Office of the Medicaid Inspector General has a single goal and purpose: to ensure compliance with the law as it relates to Medicaid benefits. The OMIG will primarily investigate and coordinate efforts against providers, agencies, and managed care entities regarding Medicaid payments and claims. When some sort of fraud or abuse of the system is found, this agency will also work to prosecute and recover any funds that were lost.
Along with their enforcement efforts, the OMIG will also work to educate care agencies, providers, and other related state agencies as to proper procedures and practices. In this way, they try to prevent future abuse or irregularities. They also focus on self-investigation so that agencies will be able to handle their own internal matters. Lastly, they have a compliance program that agencies need to abide by if they want to have access to Medicaid funds.
How Do These Investigations Happen?
The first thing that should be said here is that the OMIG specifically goes after allegations where an agency did not attempt to prevent the fraud from happening. Some fraud will inevitably slip through the cracks, but the OMIG only targets those allegations that involve either negligence or complicity from agencies and related individuals.
Once they take on a case, the OMIG will then conduct an investigation, collecting all necessary evidence, conducting interviews, and carrying out similar actions in order to pursue and prosecute their case. They also have the ability to seize pertinent documents, demand or subpoena records, and compel testimony if needed.
If there is evidence of fraud or abuse, the OMIG will then likely pursue civil actions or even administrative ones in order to recover the funds. Along with this, the OMIG also has the ability to coordinate with regulator agencies as well as licensing boards, withhold pertinent funds, impose penalties such as financial sanctions, remove providers from participation in federal programs, and even refer cases to the appropriate MFCU, or Medicaid Fraud Control Unit, for criminal charges when appropriate.
What Are the Consequences?
Along with the previously mentioned penalties like repayment of fines and being withheld from federal programs and the like, those charged can face fines of up to $500,000 and even 10 years in prison. On top of all of that, when a healthcare provider is involved in any sort of scheme, they can be barred from ever again participating in Medicaid, severely limiting any future client base they might have.
What to Do in an OMIG Investigation
Finding yourself under investigation by the OMIG can be overwhelming. The first thing that you should remember should you end up in this kind of situation is that you should not speak directly with any investigator. It is true that you have an affirmative duty to cooperate in any investigation you find yourself involved in, but that does not mean that you have to communicate with the investigator or investigators directly.
In fact, almost every defense attorney out there will in fact advise you to never speak with them and to run every bit of information you have by counsel first before anything is communicated to investigators. The reason for this is obvious: OMIG investigators will use anything and everything at their disposal to incriminate you and prosecute you. An investigator’s sole job is to pursue and prosecute cases. They are not your friend, your defense attorney is. Keep that in mind as you proceed through the investigation, and you’ll be on your way to a successful outcome.
Who to Turn to For Help
Not every legal firm is equal, and this means that outcomes can vary greatly depending on who you choose to represent you. The right defense attorney can literally be the difference between steep fines and a harsh prison sentence or you get to walk away from the experience unscathed. There are plenty of legal firms out there, some of them with slick marketing campaigns, but few that are qualified to help you the way that the Norman Spencer Law Group can.
Norman Spencer Law is Here For You
With a combined 70+ years of experience representing cases of all types, including ones that look just like yours, the Norman Spencer Law Group is uniquely positioned to get you the help that you need. We’ve represented people from all walks of life, and no case is too big or too small, too simple or complex. So if you’re facing legal trouble, get in touch with us today. Someone from our team will get back to you as soon as possible, and we’ll get started on getting you the help that you both need and deserve.