Home Health & Hospice Week

Nearly $1.5 billion in recoveries keeps the OIG on task.

If you’re waiting for federal fraud-fighting efforts to lighten up, you’ll be waiting a long time.

So indicates the latest HHS Office of Inspector General Semiannual Report to Congress. In the report, the OIG discloses that the first half of fiscal year 2018 was a big one, including major recoveries and savings. The agency recorded audit receivables at $187.5 million, garnered about $1.5 billion in savings, and looked into questionable activity that amounted to around $680 million.

“Each day, OIG uses data-driven decision making to combat fraud, waste, and abuse of Federal health care programs and to improve the effectiveness of Department programs,” says Inspector General Daniel R. Levinson. “Our multidisciplinary team of auditors, investigators, evaluators, analysts, and attorneys strategically focuses on fraud prevention, detection, and enforcement efforts.”

The reporting period, which runs from October 1, 2017 through March 31, 2018, saw some significant financial gains for the feds as well as substantial punishments against offenders. Take a look at the breakdown over the six-month timeframe, according to the Semiannual Report:

• Investigative recoveries. OIG hopes to fully recover $1.46 billion paid out improperly.
• Criminal actions. The agency brought judgments against 424 individuals who executed crimes against HHS programs.
• Civil actions. Over the six months, 349 individuals were found guilty of civil offenses.
• Exclusions. The agency banned 1,588 individuals and/or entities from participating in federal healthcare programs.
• Sanctions. The OIG levied 1,678 administrative sanctions over the six months.
• Civil Monetary Penalties. Utilizing the Civil Monetary Penalty Law (CMPL), “OIG concluded cases involving more than $35.5 million in CMPs and assessments,” a release says.

Note: For the home health- and hospice specific enforcement actions the OIG highlighted in the report, see Eli’s HCW, Vol. XXVII, No. 22.