Meet James G. Sheehan: A lifetime in public service

8 minute read

GI: Tell us about your career at the U.S. Department of Justice (DOJ) and when and where it started.

JS: I started in the Philadelphia U.S. Attorney’s office after three years with a private firm. I stayed with that office until 2007 as an Assistant U.S. Attorney (AUSA) and in various supervisory roles. I was fortunate to be in the office when the first Medicare kickback case—United States v. Greber 760 F. 2d 68 (3d Cir. 1985)—was decided, and Philadelphia became a national center for healthcare fraud enforcement. The next year, Congress amended the False Claims Act (FCA) to increase the incentives to and protection of whistleblowers, and Philadelphia became a national center for healthcare whistleblower cases. For the remainder of my career there, I worked on major whistleblower cases against teaching hospitals, major national laboratory firms, and pharmaceutical and device manufacturers.

GI: What did you learn about enforcement and compliance at DOJ?

JS: I learned how important it was to encourage and protect whistleblowers to enable people to come forward both within an organization and the government to disclose and address wrongdoing. I also began to see how encouraging effective compliance programs could reduce fraud and abuse and give employees, vendors, and customers confidence that the organization was committed to doing the right thing and supportive of those who came forward.

GI: What about your time as the chief integrity officer of the Department of Social Services in the City of New York; what did you learn on that job and its connection to compliance in the healthcare industry?

JS: It was my first job as a compliance officer responsible for overseeing compliance for over 10,000 employees and three million beneficiaries. The day I started, the city signed an FCA settlement of Medicaid claims for $70 million. The individual who brought the action remained a New York City employee, and I saw for the first time the challenge of dealing with the emotions of other employees about a whistleblower. As a compliance officer, I also learned how critical it is that leadership not only supports my work but that the support be visible to employees and vendors. I met weekly with the commissioner in one-on-one meetings and was also included in all major senior manager group meetings. The relationship with general counsel was important; whatever my credentials or advice, I was often asked, “Yes, but what does the general counsel think?” Fortunately, the relationship was cooperative and collegial.

One challenge I had not anticipated was the difficulty of getting answers on policy or billing issues from oversight agencies (common since the Department of Social Services administers and bills for state and federal programs and combined state–federal programs). When I was an AUSA, people would answer my calls and research my questions. At the city, it often seemed that the knowledgeable person in the state agency had just retired, and their IT materials were deleted.

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