The OIG has issued their Semiannual Report to Congress for the period October 1, 2023 through March 31, 2024. The report highlights over $2.76 billion in expected investigative and audit recoveries identified during the first half of FY 2024. The report details the OIG’s ongoing work through investigations and enforcement actions which include:
- 60 audits and 18 evaluations
- 712 civil and criminal actions
- 1,795 exclusions
- 1,201 referrals to prosecutorial partners (i.e. DOJ and state/local partners)
- 195 new recommendations
The types of issues identified that contributed to the expected $2.76 billion in expected recoveries include:
- Improper risk adjustment coding
- Billing for services not rendered
- Unnecessary genetic testing
- Unnecessary durable medical equipment
- Anti-kickback and Stark violations
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/documents/sar/9905/Spring_2024_SAR.pdf |
