OIG: Healthcare fraud, abuse recoveries up $1 billion in 2016

The Department of Health and Human Services increased its recoveries in fraudulent payments and settlements by more than a billion dollars in the first half of fiscal year 2016, according to a report released Tuesday.

The Office of Inspector General's Semiannual Report to Congress indicates the total amount of expected recoveries reported between October 1, 2015 and March 31, 2016 is $2.77 billion. That includes roughly $555 million in recoveries found through audits and $2.2 billion through investigations.

The six-month period covered by the report listed 428 criminal actions reported against individuals or groups that committed crimes against HHS programs, and 383 civil actions including false claims, administrative recoveries and civil monetary penalties. CMP recoveries have increased nearly five times over the past three years, and are expected to hit new highs during FY 2016, the report said.

The HHS' Health Care Fraud Strike Force teams brought charges against 87 individuals or entities, 100 criminal actions and $116.8 million in recoveries through investigations. The OIG also reported 1,662 individuals and entities barred from participating in federal healthcare programs during the first half of FY 2016, the report said.

The OIG report does not dig into skilled nursing-specific data, but lists fraud cases in the long-term care realm among its recovery highlights, including a pharmacy CEO who received 10 years in prison for a $79 million drug repackaging scheme that targeted nursing homes.

Click here to read the OIG's full Semiannual Report to Congress.