The OIG issued their semi-annual report to Congress yesterday. In the report they detailed their ongoing investigation and enforcement efforts related to healthcare fraud and abuse for the period April 1, 2017 through September 30, 2017. In the most current report, the OIG identified the following:
- $4.13 Billion in investigative recoveries
- Criminal actions against 881 individuals and entities
- Exclusion of 3,224 individuals and entities from Federal healthcare programs
- Civil actions against 826 individuals and entities
The specific types of healthcare fraud outlined in the report included:
- Diagnostic radiology and laboratory testing
- Home health and personal care services
- Ambulance transportation services
- Durable medical equipment
- Prescription drugs
The complete semi-annual report is located: https://oig.hhs.gov/reports-and-publications/archives/semiannual/2017/sar-fall-2017.pdf
The OIG will continue their investigative and enforcement efforts to prevent healthcare fraud and abuse. We recommend reviewing the semi-annual report along with other government and payor audit reports and fraud alerts to identify known risk areas that are applicable to your organization and conducting audits of those risk areas to ensure compliance with the Medicare guidelines.