Inspector General Testifies Regarding Health Care Fraud Enforcement
March 11th, 2011
On March 9, 2011, Inspector General Daniel R. Swinson testified before the U.S. Senate regarding the efforts of the Department of Health and Human Services and the Department of Justice to combat health care waste, fraud, and abuse, which cost U.S. taxpayers billions of dollars every year.
Inspector General Swinson testified that the OIG has opened more than 1,700 fraud investigations over the past fiscal year, resulting in over 900 criminal and civil actions and more than $3 billion in expected recovery.
Crimes covered by OIG investigations include billing for services that were never provided or were not medically necessary, misreporting costs to increase payments, paying or receiving kickbacks, and stealing the identities of providers or beneficiaries. Perpetrators of health care fraud range “from street criminals… to Fortune 500 companies…” Even organized crime has gotten into the game.
OIG’s work also includes auditing non-fraudulent errors in billing, coding, and documentation, which make up 10.5% of Medicare fee-for-service claims.
The collaboration between HHS and DOJ was born in the Health Care Fraud and Abuse Control program (HCFAC) established by HIPAA. Since 1997, HCFAC has returned over $18 billion of taxpayer money to the government; and the return on investment for the program has reached an all-time high of $6.80 returned for every dollar spent.
Click here for the full transcript of the testimony.
Entry Filed under: News
Trackback this post