OIG Report on Recovery Audit Contractors’ Fraud Referrals Download the complete report HERE Excerpts from EXECUTIVE SUMMARY OBJECTIVES To determine the extent to which: recovery audit contractors (RAC) referred cases of potential fraud to the Centers for Medicare & Medicaid Services (CMS) during the demonstration project, and CMS provided training to RACs regarding fraud identification […]
RACs identify fraud cases and improper payments The Centers for Medicare & Medicaid Services (CMS) conducted a demonstration project from 2005 to 2008 to detect and correct past improper payments in the Medicare fee-for-service program, and to provide information to CMS and the Medicare claims processing contractors that could help protect Medicare trust funds by […]
Realized Nearly $4 Billion in Settlements, Fines, Penalties & Restitution In fiscal year (FY) 2009, OIG’s enforcement efforts resulted in over 670 criminal actions, of which 515 involved heath care fraud; over 362 civil actions (355 involved health care fraud); and realized nearly $4 billion in settlements and court-ordered fines, penalties, and restitution, approximately 75 […]