HHS Watchdog Reports $5.56 Billion in Recoveries and Savings

The HHS Office of Inspector General reported $5.56 billion in expected recoveries and projected savings for the six months ending in March. The same report recorded 1,212 exclusions from federal healthcare programs and a return of $12.70 for every dollar spent on oversight.

Combined criminal and civil actions totaled 604, down from 833 in the prior reporting period. Criminal referrals fell to 1,168 from 1,451. Exclusions also continued a two-year decline, dropping from 1,795 in the earlier period. The figures showed no increase compared with the same six months under the previous administration.

A telemedicine software executive received a 15-year prison sentence in connection with a $1 billion fraud scheme. Settlements of $674 million were reached with Kaiser Permanente affiliates and CVS Health's Aetna over Medicare Advantage billing practices.

The total monetary impact figure combines projected savings with amounts ordered or agreed to be repaid rather than cash already collected. The report noted improper payments to deceased enrollees across 35 states, Puerto Rico and Washington, D.C. Audits in Indiana, Wisconsin, Maine and Colorado identified hundreds of millions of dollars in improper payments for applied behavior analysis therapy due to documentation errors and weak oversight.

“The figures should not be interpreted as funds already collected." — Glossary note in the semiannual report The report is the first signed by the current inspector general, a Republican lawyer confirmed by the Senate in December.”