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ENFORCEMENT

OIG celebrates 40 years of fighting fraud

October 15, 2016 marked 40 years since the U.S. Department of Health & Human Services (HHS) Office of Inspector General (OIG) was launched in 1976. It is now the largest inspector general with 1,600 employees and 70 offices and oversees $1 trillion in spending.

The HHS OIG is charged with fighting fraud, waste and abuse in federal health care programs—primarily Medicare and Medicaid, but it also oversees the Centers for Disease Control and Prevention and the Food and Drug Administration.

Here are some highlights about the agency’s recent successes:

  • The OIG reports a return on investment of $6.10 for each dollar spent
  • For the first half of 2016, the agency expects about $2.77 in recoveries
  • The OIG’s claims its report recommendations yielded $20.6 billion in savings for fiscal year 2015

The OIG’s 2017 budget request totaled $419 million including $334 million for Medicare and Medicaid oversight and the Health Care Fraud Prevention and Enforcement Action Team (HEAT) initiative. Enforcement targets include “fraud and wasteful spending, including improper payments, unsafe or poor quality health care and security of data and technology.”


Editor’s picks:

Expect more concerted HIPAA enforcement due to OIG reports


Practices recognize that health care compliance management must be addressed, despite challenges


Medical biller sentenced to 45 months in prison for role in $4 million health care fraud scheme


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