The OIG issued their Semi-Annual Report to Congress on June 1, 2018. The report outlines the OIG’s activities for the period October 1, 2017 through March 31, 2018. The OIG identified the following enforcement achievements for the most recent 6 month period:
- Expected recoupments of $1.46 billion
- Criminal actions against 424 individuals/entities
- Exclusion of 1,588 individuals/entities
- Civil actions against 349 individuals/entities.
The report also outlines the significant areas which resulted in the $1.46 billon recoveries. The issues identified by the OIG include:
- Failing to comply with medical necessity, coding and documentation requirements for outpatient physical therapy services
- Non-covered hyperbaric oxygen therapy services
- Medically unnecessary home health services
- Ineligible and medically unnecessary hospice services
- Improper reporting of manufacturer device credits
- Drug manufacturer kick-back violations
We recommend you review the Semi-Annual report and conduct proactive audits of identified known risks that are applicable to your organization.
The complete Semi-Annual Report can be found at https://oig.hhs.gov/reports-and-publications/archives/semiannual/2018/sar-spring-2018.pdf