The Office of Inspector General (OIG) recently published its Semiannual Report to the U.S. Congress. This Report summarizes the OIG’s enforcement activities from March, 2013 to September, 2013.
The Report highlights the OIG’s significant efforts in the enforcement of fraud and abuse laws. For fiscal year (FY) 2013, the OIG is expecting total recoveries of $5.8 billion, consisting of nearly $850 million in audit receivables and about $5 billion in investigative receivables.
Additionally, for FY 2013, the OIG brought 960 criminal and 472 civil actions against individuals or entities that engaged in health-care-related offenses. Compared with FY 2012, the number of criminal actions in FY 2013 rose by 182 cases, and the number of civil cases rose by 105 cases.
According to the OIG, these enforcement results are partially due to the successes of the Health Care Fraud Prevention and Action Team (HEAT). HEAT is a partnership between Federal, State, and local law enforcement to identify fraudulent health care schemes. The program combines sophisticated data analysis and investigative intelligence to move quickly against violators of fraud and abuse laws such as the False Claims Act.
There is no doubt that the OIG’s accomplishments in FY 2013 will motivate investigators to root out more health care fraud and overpayment schemes in FY 2014. To avoid a costly investigation and potential prosecution, providers should take extra care that they are following Medicare and Medicaid laws and properly billing for services rendered to patients.
You can read the entire OIG Semiannual Report here.
For more information about health care fraud and abuse laws, please contact Casey Moriarty.