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 percent of which involved health care fraud, according to testimony by Timothy Menke, Deputy Inspector General for Investigations at the U.S. Department of Health & Human Services’ (HHS) Office of Inspector General (OIG), before the Subcommittee on Crime, Terrorism, and Homeland Security of the House Committee on the Judiciary on law enforcement activities to combat Medicare and Medicaid fraud, on March 4, 2010.
Focuses 80% of Resources on Protecting Medicare and Medicaid Programs
“Approximately 80 percent of OIG’s resources are dedicated to promoting the efficiency and effectiveness of the Medicare and Medicaid programs and protecting these programs and program beneficiaries from fraud and abuse,” said Menke. The OIG employs nearly 400 skilled criminal investigators, using state-of-the-art technologies and a wide range of law enforcement tools, including full authority for the execution of searches and making arrests.
The OIG is closely tied to one of the Obama Administration’s signature initiatives, the Health Care Fraud Prevention and Enforcement Action Team (HEAT). “This is a joint effort by HHS and DOJ to leverage resources, expertise, and authorities to prevent fraud and abuse in Medicare and Medicaid,” said Menke.
HEAT was established by Secretary Sebelius and Attorney General Holder in May 2009, to bring together senior officials from both Departments with the stated goals of sharing information, spotting fraud trends, coordinating prevention and enforcement strategies, and developing new fraud prevention tools. OIG contributes its expertise to HEAT by analyzing data for patterns of fraud; conducting investigations; supporting Federal prosecutions of providers who commit criminal and civil fraud; and pursuing administrative remedies, including program exclusions.
Find Mr. Menke’s complete testimony HERE.
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