The Office of the Inspector General Fraud Recoveries Dropped $1.2 Billion This Year

That might not be a bad thing.

 

The federal government brought in 30% less in fraud recovering in 2018 than it did the previous year, thanks to far few large settlements. But the could be a net benefit, according to the Centers for Medicare & Medicaid Services (CMS). The office of Inspector General (OIG) recovered $2.9 billion from fraud investigations during fiscal year 2018, according to the semiannual report to Congress released last week. That’s  $1.2 billion decline from last year, when the agency pulled in $4.13 billion (Sweeney, 2018)

The year prior, the agency hauled in a historic $5.6 billion.

But lower recoveries are not indicative of lighter enforcement, according to OIG spokesperson Don White. Fraud recoveries fluctuate from year to year, based primarily on the volume of large settlements. In 2017, for example, the OIG inked a $155 million settlement with EHR vendor eClinicalWorks and Mylan paid $465 million in an EpiPen settlement. The prior year, Tenet Healthcare forked over more than $500 million (Sweeney, 2018).

On another note…a little alarming because CMS does budget in a % of recovery dollars to justify their fraud investigation program.

Resources

Sweeney, E. (2018). OIG fraud recoveries dropped $1.2B this year. That might not be a bad thing. FierceHealthcare.com. Retrieved from: https://www.fiercehealthcare.com/payer/oig-fraud-recoveries-dropped-almost-1-2-b-year-might-not-be-a-bad-thing

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