Fraud investigations, audits bring dramatically rising 'savings,' OIG reports

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The projected recoveries to the federal government from fraud-related audits and investigations are expected to rise 33% — or by $1.7 billion — in fiscal 2012, the Department of Health and Human Services Office of the Inspector General said this week.

OIG expects recoveries of $6.9 billion this year, according to the agency's Semiannual Report to Congress. Some of that recuperation came from the Medicare Fraud Strike Force, which filed criminal charges against more than 300 people or entities and got 181 convictions. It found $1.2 billion from training contractors to identify claims where Medicare is not the primary payer, and $900 million by reducing Medicare payments for durable medical equipment.

The OIG also counted a $3 billion settlement reached with GlaxoSmithKline, a $628 million settlement with Merck over alleged marketing efforts and a $187 million settlement with McKesson of alleged inflation of prescription drug pricing.

Long-term care operators are among the healthcare providers who have faced an increase in special audits in recent months and years.

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