Kusserow on Compliance: 2014 OIG Year in Review

The HHS Office of Inspector General (OIG) posted  more than 35 podcasts to their website in 2014.  The latest podcast is a summary of their 2014 Year in Review that looked back at highlights of their activities.

  1. The OIG reported nearly $5 billion dollars in expected recoveries in fiscal year 2014. The recoveries resulted from program audits and investigations.
  2. The OIG reported 971 actions against individuals or entities that engaged in crimes against HHS programs as well as 533 civil actions during the fiscal year.
  3. Medicare Strike Force efforts by the OIG and its partners at the Department of Justice resulted in the filing of charges in 232 criminal actions.
  4. Six OIG Most Wanted fugitives were captured during the year.
  5. The OIG excluded more than 4,000 individuals and entities from participation in federal health care programs during 2014. Among them was pediatric dental management chain CSHM, for “repeated and flagrant violations” that put kids at risk.
  6. The OIG negotiated more than 40 corporate integrity agreements (CIAs), among them one with the Extendicare nursing home chain that alleged “effectively worthless care.” Extendicare agreed to pay $38 million dollars.
  7. The OIG found that, after Health Insurance Marketplaces first opened, they faced major challenges with inconsistencies in applicant data.
  8. In its report, Access to Care: Provider Availability in Medicaid Managed Care, the OIG found that slightly more than half of Medicaid managed care providers could not offer appointments to enrollees.
  9. The OIG testified at 10 hearings on Capitol Hill in 2014. You can read that testimony on the OIG website.

Other reports summarizing OIG activities in 2014 include its Semi-Annual Reports to Congress, OIG Work Plan, and OIG Budget Proposal.

Richard P. Kusserow served as DHHS Inspector General for 11 years. He currently is CEO of Strategic Management Services, LLC (SM), a firm that has assisted more than 3,000 organizations and entities with compliance related matters. The SM sister company, CRC, provides a wide range of compliance tools including sanction-screening.

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Copyright © 2015 Strategic Management Services, LLC. Published with permission.