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OIG Fall 2022 Semiannual Report

OIG Fall 2022 Semiannual Report December 7, 2022

The OIG has issued their Semiannual Report to Congress for the period April 1, 2022 through September 30, 2022.  The report highlights over $4 billion in expected investigative and audit recoveries identified during the entirety of FY 2022. The report details the OIG’s ongoing work through investigations and enforcement actions during this audit period which include:

  • $62.9 million in recoveries from audits
  • $1.29 billion in expected investigative recoveries
  • 390 criminal actions
  • 416 civil actions
  • 1,290 excluded individuals

The types of issues identified that contributed to the nearly $4 billion in expected recoveries include:

  • COVID testing related schemes
  • Opioid related fraud
  • Improper risk adjustment coding
  • Prescribing medically unnecessary items/services
  • Improper billing of the following types of services:
    • Critical care services
    • Durable Medical Equipment (DME)
    • Facet-joint denervation
    • ESRD
    • Critical Access Hospitals (CAH)
    • Home health
    • Hospice

We recommend reviewing the Semiannual Report in its entirety to identify risks that are pertinent to your organization.  Identified areas of risk should be evaluated as part of your compliance program’s auditing and monitoring efforts.

The Semiannual report can be found here: https://oig.hhs.gov/reports-and-publications/semiannual/index.asp

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