HHS-OIG Report Details Expected Recoupment of $3.44 Billion

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1/31/2024

On December 1, 2023, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) announced it expects to recoup billions of dollars in Medicare, Medicaid and other health and human services funds.

The fall 2023 Semiannual Report to Congress details HHS-OIG’s efforts identifying abuses, deficiencies, risks, and investigations relating to the administration of HHS programs. $3.44 billion of taxpayer funds will be recovered as a result of HHS-OIG audits and investigations from October 1, 2022 to September 30, 2023. In fiscal year 2023, HHS-OIG excluded 2,112 individuals and entities from participation in federal health care programs, reported 707 criminal enforcement actions against those engaging in crimes targeting HHS programs, and reported 746 civil actions, including false claims lawsuits.

Additional findings detailed in the report include:

• Medicare improperly paid providers for psychotherapy services, including those provided via telehealth, during the first year of the COVID-19 emergency.

• Many Medicaid enrollees with opioid use disorder were treated with medication (referred to as MOUD). However, one-third of the 1.5 million Medicaid enrollees with opioid use disorder did not receive MOUD in 2021. Certain demographic groups were found less likely to receive MOUD.

• CMS did not accurately report on its website, Care Compare, deficiencies that State surveyors identified during yearly and complaint inspections of Medicare and Medicaid-certified nursing homes.

Click Here to read the entire January 2024 Healthcare Law Update now!

For more information, contact:
Isabelle Bibet-Kalinyak, Vice Chair | 973.403.3131 | ibibetkalinyak@bracheichler.com
Edward J. Yun | 973.364.5229 | eyun@bracheichler.com
Cynthia J. Liba | 973.403.3106 | cliba@bracheichler.com

*This is intended to provide general information, not legal advice. Please contact the authors if you need specific advice.

Related Practices:   Healthcare Law

Related Industry:   Healthcare