OIG Reports Expected Recoveries of $3.1 Billion in First Half of FY 2014

stacks of moneyThe Department of Health and Human Services Office of Inspector General (OIG) expects to recover more than $3.1 billion for the first half of fiscal year (FY) 2014, according to its latest Semiannual Report to Congress released May 27. The expected recoveries consist of nearly $295 million in audit receivables and about $2.83 billion in investigative receivables, the report said.

According to OIG, 1,720 individuals and entities were excluded from participating in federal health care programs in the first half of FY 2014. OIG also reported 465 criminal actions and 266 civil actions commenced during the semiannual report time period (October 1, 2013 to March 31, 2014).

OIG also noted Medicare Fraud Strike Force team efforts resulted in the filing of charges against 94 individuals or entities, 107 criminal actions, and $294.1 million in investigative receivables.

The report highlighted in particular several major settlements involving prescription drugs, including a more than $2.2 billion settlement with Johnson & Johnson of criminal and civil allegations related to Risperdal, Invega, and Natrecor. The allegations included promoting the drugs for off-label uses and paying kickbacks to physicians and to long term care pharmacy Omnicare, Inc., the report said.

In an opening message included in the report, Inspector General Daniel R. Levinson said during the reporting period, “OIG ramped up its oversight of the Department’s efforts to implement the Affordable Care Act, including the Health Insurance Marketplaces.”

He noted OIG “has a substantial body of work underway focusing on core risk areas associated with the Marketplaces, such as eligibility systems, payment accuracy, contractor oversight, and data security.”

Levinson said forthcoming reports would include recommendations “to address vulnerabilities and better ensure Marketplaces operate efficiently and effectively.”



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