OIG Recovers More Than $2 Billion in Civil Monetary Penalties This Year
HCPRO Website, June 13, 2016
The Office of Inspector General (OIG) recovered more than $2.77 billion in civil monetary penalties (CMP) during the first half of the year, according to the office’s Semiannual Report to Congress, released May 31. The OIG expects that figure to continue to rise through the second half of the year.
According to the report, roughly $554.7 million of the total was recovered from audit receivables and $2.22 billion in investigative receivables. More than $330 million of investigative receivables was recovered from non-HHS sources such as state shares of Medicaid restitution.
The OIG’s investigations this year resulted in 428 criminal charges against individuals or entities and 383 civil actions, including false claims lawsuits and administrative recoveries related to provider self-disclosure matters. More than 1,600 individuals and entities were excluded from participation in federal healthcare programs.
This year’s rise in CMP recoveries is part of a trend that’s seen CMP recoveries increase nearly five times over the past three years, the report says. The OIG expects this year’s CMP recoveries to surpass the amounts recovered in previous years.
The OIG’s healthcare fraud strike force teams’ efforts alone netted $116.8 million in investigative receivables, 100 criminal actions, and 87 charges against individuals or entities during the first half of the year. The strike force teams are a component of the OIG’s Health Care Fraud Prevention and Enforcement Action Team (HEAT). HEAT strike teams coordinate law enforcement operations, including investigation and prosecution of fraud. Strike force models operate in select cities, including Miami, Chicago, and Dallas.
The OIG is required to create semiannual reports for HHS and Congress detailing the activities of the office during the previous six months. The report highlights problems, abuses, and deficiencies the OIG found in HHS programs and investigative outcomes.
Most Popular
- Articles
-
- Practice the six rights of medication administration
- Differentiate between types of wound debridement
- ICD-10-CM coma, stroke codes require more specific documentation
- Note similarities and differences between HCPCS, CPT® codes
- Don’t forget the three checks in medication administration
- Know guidelines and subtle differences in code descriptions for laceration repairs
- Fracture coding in ICD-10-CM requires greater specificity
- Complications from immobility by body system
- OB services: Coding inside and outside of the package
- 2018 trends in medical specialty choice
- E-mailed
-
- Kiosks smooth ED traffic at Dallas' Parkland Memorial
- MA medical licensing board fines physician for privacy violation
- Injections and infusions continue to confuse coders
- Immediate Jeopardy - Why this finding can be disastrous to your facility.
- How to get reimbursed for restorative nursing
- Get the facts on emergency department FAST exams
- Coding, billing, and documentation tips for teaching physicians, interns, residents, and students
- CMS adds 10 new comprehensive APCs for 2016
- Allocating overhead fairly when paying your members
- 10 Tips for Educating Elderly Patients
- Searched