Healthcare Business News

OIG sets record in funds recovered

By Joe Carlson
Posted: November 27, 2012 - 6:45 pm ET

HHS' office of the inspector general this year continued its steady march upward in the number of new criminal cases it helped file and the amount of misspent federal healthcare dollars it recovered, setting five-year records in both categories, figures show.

The office helped to recoup $5.2 billion in expected HHS “receivables” stemming from investigations its auditors and officials were involved with in fiscal 2012, according to the HHS OIG Semiannual Report to Congress (PDF) summarizing results of the fiscal year ended Sept. 30.

Expected HHS receivables averaged $4.2 billion a year between 2008 and 2012, according to annual reports from those years.

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The federal government lost at least $64 billion to fraud, waste and improper payments in 2011, the most recent year for which a figure was available, Inspector General Daniel Levinson wrote in the report.

HHS “continues to face significant management and performance challenges in key areas, including reducing improper payments and avoiding waste, ensuring patient safety and quality of care, and overseeing program integrity contractors,” Levinson wrote in an introduction to the report. “As the department implements the Affordable Care Act and other healthcare reforms, it faces challenges in ensuring that these issues are not carried over into new programs and dimensions of existing programs.”

The office participated in criminal cases against 778 individuals or entities accused of fraud or other crimes against HHS programs in 2012, while averaging 679 a year since 2008. Meanwhile, the number of civil cases filed was 367 in 2012 compared to the five-year average of 373.

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