Agency inspectors general can’t solve the government’s deficit problem on their own, but they can – and do – recoup ill-gotten gains that add up to a tidy sum. That’s especially true when massive government programs are involved.
Medicare and Medicaid are two such gargantuan programs within the Department of Health and Human Services, and they are often targets of fraud. So the HHS Office of Inspector General devotes 80 percent of its resources to Medicaid and Medicare oversight. That focus paid off in 2012, when the office recovered $6.9 billion, according to its semi-annual report to Congress.
The office also recommended changes to laws, regulations and administrative procedures that, according to the Government Accounting Office, saved the government another $8.7 billion. Not a bad return on taxpayers’ dollars for a body whose 2012 budget was $376 million. (The IG is asking for $13 million more this year.)
Besides conducting their own investigations, Health and Human Services’ IGs take part in inter-agency programs. HEAT (Health Care Fraud Prevention and Enforcement Action Team) pairs them with the Department of Justice, while Medicare Strike Force Teams involve state and local law enforcement.
On May 2, 2012, a HEAT team of more than 200 carried out a “coordinated takedown” in seven cities that resulted in criminal charges against 107 people for fraudulent Medicare billing.
Another tool in the HHS IG’s arsenal is its ability to recommend that certain individuals or entities be excluded from Medicaid, Medicare and other health care programs as punishment for fraud. The IG did plenty of excluding in 2012, barring 3,131 individuals and entities from participating in government health care programs for some period of time. Among them was Dr. Conrad Murray, physician to the late pop star Michael Jackson. Murray was excluded from federal healthcare programs for 50 years after his conviction for involuntary manslaughter in Jackson’s death.
The Inspector General Act of 1978 requires inspectors general to report on their activities to their agency heads and Congress twice a year.
Please view the blog article written by Marci Greenstein here.