OIG: Improper payment gains up $2.3 billion for FY 2016

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Federal health officials recovered more than $5.66 billion in improper or fraudulent payments in fiscal year 2016, according to a report published Thursday. The recovery cases included a nursing home cited for a lack of following care plans.

The Department of Health and Human Services Office of Inspector General's Semiannual Report to Congress showed that the total amount of expected recoveries reported by the agency jumped roughly $2.3 billion. In fiscal year 2015, $3.4 billion was taken back by the federal government.

Skilled nursing providers appeared in the report as examples of cases taken on by the OIG for the semiannual reporting period stretching from April 1, 2016 to Sept. 30, 2016.

Those cases include a “quality of care” endeavor against a Louisiana nursing home that did not always follow care plans, leading to some residents being hospitalized for potentially avoidable urinary tract infections. The OIG report also highlighted research released last summer that found 29% of Medicare beneficiaries sustained some type of harm during their stay at rehabilitation hospitals, as well as a massive fraud sweep that resulted in charges against 301 providers.

In total, the agency reported 844 criminal actions in FY 2016 against individuals and organizations engaged in crimes against federal healthcare programs. OIG also reported 709 civil actions, which include false claims, and exclusions of 3,635 individuals and organizations from participation in federal healthcare programs for the fiscal year.

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