Posts Tagged ‘Office of the Inspector General’
OIG to Recover $4B in 2020 Resulting From Investigative Efforts
The U.S. Department of Health and Human Services Office of Inspector General recently reported that it expects to recover more than $4 billion in misspent Medicare, Medicaid and other HHS dollars as a result of its investigative efforts. While that is a lot of money, it is considerably less than the nearly $5.9 billion the…
Read MoreFeds target healthcare fraud by looking for outliers
Last week, the U.S. Department of Justice announced the largest healthcare fraud takedown in its history. Approximately 300 defendants in 36 federal districts, including South Florida, were charged with engaging in fraudulent billings to the tune of more than $900 million. Charges included: conspiracy to commit healthcare fraud, violations of the anti-kickback statutes, money laundering…
Read MoreStates’ failure to implement NCCI edits cost Medicaid program billions annually
Improper payments to healthcare providers cost the Medicaid program approximately $17.5 billion in fiscal year 2014, according to a new report from the HHS Office of the Inspector General. The reason: States’ failure to fully implement or properly use Medicaid National Correct Coding Initiative (NCCI) edits. The purpose of the NCCI edits is to prevent…
Read MoreOIG opinion: Free transportation doesn’t violate anti-kickback statute
The U.S. Department of Health and Human Services Office of Inspector General recently issued an opinion stating that a large healthcare system’s free van shuttle service for patients does not violate the federal anti-kickback statute. The statute makes it a criminal offense to knowingly and willfully offer, pay, solicit, or receive any remuneration to induce…
Read MoreMedicare Part D fraud fastest growing component of program
When the Department of Justice earlier this month announced the arrest of 243 people for Medicare fraud, it noted that 50 of the defendants were charged with crimes related to the Medicare prescription drug benefit program known as Part D. Prescription drug fraud has become the fastest-growing component of the Medicare program overall, and is…
Read More