Yesterday, the OIG issued their Semiannual Report to Congress for the reporting period October 1, 2018 to March 31, 2019.  The report details the OIG’s ongoing work through investigations and enforcement actions in fighting healthcare fraud, waste and abuse.  The OIG continues to partner with multiple government agencies like the Department of Justice, the Federal Bureau of Investigation, U.S. Attorney’s Offices, Medicaid Fraud Control Units and other Federal and State programs that result in positive enforcement outcomes such as:

• $2.3 billion in expected recoveries
• 421 criminal actions
• 1,293 excluded individuals and entities
• 331 civil actions

The report identified the types of services targeted which are widely consistent with prior investigations and are consistent with areas identified in the OIG Work Plan.  Some of the Medicare specific related investigations and fraud recoveries involved the following:

• Teaching physician services
• Radiation therapy services
• Durable medical equipment (DME)
• Hyperbaric oxygen therapy services (HBO)
• Skilled nursing facilities

Nationwide investigations during this reporting period resulted in a couple of the largest ever law enforcement takedowns involving healthcare schemes: 

• Operation Brace Yourself involved allegations of $1 billion in paid orthopedic braces that were alleged as medically unnecessary; and
• The largest ever law enforcement takedown in 5 states for prescription opioids.

The entire OIG Semiannual Report to Congress can be found here: https://oig.hhs.gov/reports-and-publications/archives/semiannual/2019/2019-spring-sar.pdf