On June 1, 2011, the Office of Inspector General (OIG) announced that it expects to recover an estimated $3.4 billion in connection with its Medicare and Medicaid investigations, audits, and reviews. The amount was accrued between October 2010 and March 2011 in the form of penalties, fines, and settlements. Of the estimated $3.4 billion in recoveries, $222 million stems from audits while $3.2 billion arose from 349 criminal and 197 civil actions. The OIG featured the following items in its Semiannual Report to Congress:
•· 100 healthcare professionals were arrested for their participation in various healthcare-related crimes (e.g. violating the anti-kickback statute and money laundering) which resulted in $225 million in false billing.
•· Two drug companies, GlaxoSmithKline and Allergan USA, agreed to pay $750 million and $600 million, respectively, to resolve various charges.
•· 13.5% of the one million Medicare beneficiaries discharged from hospitals experienced adverse events during hospital stays in October 2008, 44% of which were found to be preventable.
•· In February, OIG launched a series of provider compliance training sessions across the U.S. in an effort to help prevent health care fraud and improve compliance.
If you need help defending against Medicare/Medicaid audits or investigations, or assistance with implementation of a proactive corporate compliance program, please contact a Wachler & Associates attorney at 248-544-0888.