OIG To Recover More Than $3 Billion in Healthcare Fraud Enforcement

In its semiannual report to Congress this week, the Department of Health and Human Service’s (HHS) Office of Inspector General (OIG) announced that it expects to recover more than $3 billion from enforcement activities conducted in the six-month period that ended March 31. In the same time period, the OIG:

• Excluded 1,935 individuals and entities from participation in federal health care programs;
• Brought 293 criminal actions against individuals or entities; and
• Initiated 164 civil actions (including some under the False Claims Act, unjust enrichment lawsuits, civil monetary penalties law settlements and administrative recoveries related to provider self-disclosure).

In the months ahead, the OIG will implement the healthcare fraud-related provisions in the Patient Protection and Affordable Care Act (PPACA) and oversee HHS’s healthcare reform activities. It will also continue its efforts with the Health Care Fraud Prevention & Enforcement Action Team (HEAT) in conjunction with the Department of Justice and HHS. HEAT initiatives include the Medicare Fraud Strike Force, which coordinates law enforcement operations with other federal, state and local law enforcement entities in select cities around the country.