Gov’t in line for large recovery, OIG says

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Wednesday, December 4, 2019

WASHINGTON – Taxpayers could see nearly $5.9 billion that has been misspent on healthcare services returned to the government, according to The Office of Inspector General in its Semiannual Report to Congress published this week.

Of the savings and recoveries in FY 2019, more than $819 million is expected to be recovered from audits and approximately $5.04 billion from investigative recoveries, according to the OIG.

For the reporting period, April 1– Sept. 30, 2019, the OIG reported 353 criminal and 357 civil actions against individuals or entities that engaged in offenses related to health care. It also reported more than $1.47 billion in HHS-related investigative receivables and more than $1.13 billion in non-HHS related investigative receivables, including civil and administrative settlements or civil judgments related to Medicare, Medicaid, and federal state and private healthcare programs.

The agency highlighted numerous fraud recovery efforts, including Operation Brace Yourself. In April, the OIG and various law enforcement agencies broke up a $1.2 billion fraud scheme involving medically unnecessary braces. Charges were brought against 24 defendants on allegations involving illegal kickbacks and bribes by DME companies in exchange for referrals of Medicare beneficiaries by medical professionals working with fraudulent telemedicine companies for back, shoulder, wrist and knee braces.