Posts Tagged ‘fraud and abuse’

In its Semiannual Report to Congress, the Office of Inspector General (OIG) announced Dec. 3 a reported savings and expected recoveries of $20.97 billion for 2009 as a result of audits, investigations, and evaluations the agency conducted this year.

Of that $20.97 billion, the OIG says $16.48 billion is savings based on implemented recommendations to put funds to better use; $492 million is from audit receivables; and $4 billion is from investigative receivables.

Among the OIG’s most touted accomplishments during the semiannual period between April 1 and Sept. 30 are several cases involving Medicare fraud, waste, or abuse. Read more »

The Associated Press reports that for three years, the Centers for Medicare & Medicaid Services (CMS) repeatedly ignored internal watchdog warnings about swindlers stealing millions of dollars by scamming several programs, documents show. CMS received roughly 30 warnings from inspectors over three years during the Bush and Obama administrations but didn’t respond to half of them, even after repeated letters, according to records provided to The Associated Press by U.S. Sen. Charles Grassley’s office.

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A St. Louis, Mo. podiatrist has been indicted for allegedly submitting false bills to Medicare and Medicaid, including bills for foot care on patients whose feet had been amputated, the U.S. Attorney’s office said June 12. Read more »

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) submitted its semiannual report to Congress, reporting an expected $2.4 billion in recoveries the first half of the fiscal year. Recoveries were made from providers, drug companies, other agencies, and even four states.

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Department of Justice (DOJ) Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius announced May 20 that they intend to step up efforts to combat Medicare fraud with the newly formed Health Care Fraud Prevention and Enforcement Action Team (HEAT) and Strike Force team expansion.

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The Centers for Medicare & Medicaid Services (CMS) are instructing contractors to look much more closely at claims for services billed with modifier 79 Unrelated procedure or service by the same physician during the post operative period.

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