News & Views

OIG Is the Fulcrum in the Fight Against HSS Program Fraud

The U.S. Department of Health and Human Services (HSS) provides over $1 trillion in health and human services to the American people. Every day, more than 1,600 dedicated public servants oversee these programs to maintain their efficiency, effectiveness, and integrity. OIG’s job is to ensure that Federal dollars are used as intended, and eligible citizens receive safe, high-quality services. 

As trusted guardians for taxpayers, one of OIG’s primary goals is to identify and eliminate fraud.

To accomplish this, OIG acts to combat fraud, waste, and abuse in the services by:

  • Conducting Investigations
  • Auditing and Evaluating Program Efficacy
  • Making Waste and Abuse Recommendations
  • Fostering Financial Stewardship Programs
  • Promoting Payments Compliance
  • Holding Wrongdoers Accountable
  • Recovering Misspent Public Funds

An Overview of OIG’s Fraud, Waste, and Abuse Prevention Measures

OIG works independently and in cooperation with Federal and State partners to hold wrongdoers accountable and recover misspent public funds. With help from the Healthcare Fraud and Abuse Control Program (HCFAC) funding, OIG Auditors and Special Agents with DOJ and HHS agencies on healthcare fraud enforcement activities, including qui tam cases. As part of False Claims Act cases, OIG utilizes Corporate Integrity Agreements as well as civil monetary penalties and exclusions to hold fraud perpetrators accountable and recover stolen funds. 

By excluding individuals and entities from Federally funded healthcare programs, OIG protects HHS programs, beneficiaries, and recipients. These exclusions are based on certain criminal convictions and other criteria established in the Social Security Act.  

OIG also conducts audits specifically to address HSS program integrity risks and they frequently result in changes in policy and legislation as well as significant monetary savings.  In addition to its policy, auditing and investigative functions, OIG has long been at the forefront of measuring and recommending actions to prevent improper payments. This includes Annual Reports and Priority Reports, to include Work Plans, which prioritize work on billing and payment errors, effective program administration, and grant and contract oversight. In addition, the Office works to ensure the integrity of grant application and selection processes and to protect intellectual property and research integrity. 

Conclusion

We value OIG’s investigative resources and support its mission of investigating, identifying, and eliminating fraud, waste, and abuse in all its programs.

If you have further questions on this or any Healthcare Fraud subject, contact the Whistleblower Firm – Nolan Auerbach & White, LLP. online, or by calling 800-372-8304 today.

OUR PROMISE Being a healthcare whistleblower can feel like David taking on Goliath. We help level the playing field.

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