The HHS Office of Inspector General (OIG) released its Spring 2019 Semiannual Report to Congress covering OIG activities from October 2018 through March 2019. Also, Daniel Levinson, HHS OIG Inspector General, stepped down this month after 15 years of holding his position. In this post, we’ll take a look at some of the latest updates from the HHS OIG and discover how the agency plans to move forward.
HHS OIG Daniel Levinson Resignation
Former HHS OIG Inspector General, Daniel Levinson, submitted a letter of resignation on April 2 stating his decision to step down after 15 years in his role for the department. As of June, 1 Joanne Chiedi accepted the position as acting Inspector General. Chiedi, who addressed healthcare compliance professionals at this year’s HCCA Compliance Institute served alongside Levinson for nine years.
– Daniel Levinson, Former HHS OIG Inspector General
Serving the nation as the HHS IG for the past decade and a half has been a great privilege and a high honor. I am grateful for the support of your Administration in continuing to help provide the resources necessary for this office to fulfill its important work to protect HHS programs from fraud and abuse, and to promote economy, efficiency and effectiveness in program operations”.
Mr. Levinson will surely be missed for his contributions and leadership of the Department of Health and Human Services Office of Inspector General. In his final Message of the Inspector General in the latest Semiannual Report to Congress, Mr. Levinson highlighted some of the proudest moments of his responsibilities as Inspector General.
During his time as Inspector General, Daniel Levinson lead the efforts in creating the first Medicaid Fraud Control Units (MFCUS) in 2007, and the Health Care Fraud Prevention and Enforcement Action Team, which in his words have “proven extraordinarily effective at analyzing data and investigative intelligence to identify fraud and prosecute cases quickly”.
Mr. Levinson was a critical factor in advocating and putting resources together for better technology and better evaluations of data to help improve the integrity of federal healthcare programs and combat fraud, waste, and abuse for beneficiaries. During his tenure, Levinson was at the forefront of helping to curb the opioid epidemic while using enhanced data analysis and pinpointing critical areas of improvement and oversight.
Check out one of his latest keynote addresses that were fortunate to witness at the 2018 HCCA Compliance Institute.
Levinson concluded in his final message that he is “optimistic about the future of HHS-OIG and have full confidence in the organization to advance OIG’s important mission and make a positive difference in the lives of our fellow Americans”.
Thank you very much for your thoughtfulness, leadership, and follow through as Inspector General over the years. Our organization is grateful for such a positive impact from a humble leader that was relentless in making healthcare safer and more effective for everyone.
HHS OIG Semiannual Report to Congress
What is the OIG Semiannual Report to Congress?
The OIG Semiannual Report to Congress describes OIG’s work on identifying significant problems, abuses, deficiencies, remedies, and investigative outcomes relating to the administration of HHS programs and operations that were disclosed during the reporting period. In the report, OIG publishes expected recoveries, criminal and civil actions, and other statistics as a result of their work for the semiannual reporting period.
The HHS Office of Inspector General has released its latest version of the 2019 Spring Semiannual Report to Congress to summarize OIG activities from October 1, 2018 – March 31, 2019. You catch check out all of the archived reports here – OIG Semiannual Reports Archive. Below, you will find some of the highlights, focus areas, results, and more from HHS OIG during the reporting period.
HHS OIG Work Plan
Each month, OIG releases their Work Plan updates to inform the public about the projects they are taking on during the year including auditing, reporting, and investigating HHS operating divisions, including the following:
- Centers for Medicare & Medicaid Services (CMS)
- Public health agencies such as the Centers for Disease Control and Prevention (CDC)
- National Institutes of Health (NIH)
- Administration for Children and Families (ACF)
- Administration for Community Living (ACL)
- Various state and local governments – evaluating the use of federal funds as well as the administration of HHS
*Some of the projects described in the Work Plan are statutorily required.
HHS OIG Audit Results and Excluded Individuals and Entities
- $2.3 billion reported expected investigative recoveries
- 421 individuals or entities that engaged in crimes against HHS programs
- Exclusion of 1,293 individuals and entities
- Civil actions against 331 individuals or entities
HHS OIG Priority Areas
- Opioid epidemic
- Quality of care
- Children in the Office of Refugee Resettlement facilities care
OIG Strategic Publications
To better support the work of the OIG and its approach to protect the integrity of U.S. Health and Human Services (HHS) programs, the office releases valuable resources (in accordance with OIG’s Strategic Plan for 2014-2018) throughout the year for enhanced learning, general awareness, and demonstrated value.
Take a look at how they are provided a means for annual transparency and visibility into their process and priority focus each year.
The OIG’s Strategic Plan for 2014-2018 outlines the OIG’s approach to protecting the integrity of HHS programs with four key goals:
- Fight fraud, waste, and abuse.
- Promote quality, safety, and value.
- Secure HHS programs’ future.
- Advance excellence and innovation.
Ensuring Quality of Care and Protecting Medicare Patients From Harm
OIG determined that more than 4 in 10 Medicare patients in long-term-care hospitals (LTCHs) experienced some type of harm from care. Additionally, upon medical review, it was estimated that “25 percent of Medicare patients in LTCHs experienced temporary harm events from their care and an additional 21 percent experience more serious adverse events”.
In a recent report, OIG recommended that CMS improve its guidance to state agencies on verifying nursing homes’ corrections and improve its related forms and systems to correct deficiencies including quality and safety concerns.
As the demand for care and skilled providers continue to rise, OIG “has long prioritized oversight and enforcement work to protect Medicare and Medicaid patients from harm and to help ensure that patients receive high-quality care”.
Ensuring Program Integrity and Effective Administration of the Medicare Program
– OIG Semiannual Report, Spring 2019
Reducing improper payments and ensuring that Medicare funds are spent efficiently, effectively, and economically is crucial. In FY 2017, Medicare spent nearly $700 billion, representing more than 15 percent of all Federal spending, and provided health coverage to 58.4 million beneficiaries.”
Multiple reports have indicated that due to the estimated growth of Medicare and federal healthcare spending, it is critical that improper payments are diminished in regards to affordable spending. It is currently projected that the Medicare Part A Trust Fund will be depleted by 2026 and that spending for Medicare Part B will grow faster than the U.S. economy for the next 5 years.
Some significant work has been done from HHS OIG to address these concerns during the semiannual reporting period.
Here are a few examples:
OIG recommended that CMS recover $1.6 billion due the Federal Government in Medicaid overpayments. CMS has not recovered all of the overpayments identified in OIG audit reports in accordance with Federal requirements
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Written by Michael Rosen, Esq.
Michael brings over 20 years of experience founding and leading risk mitigation businesses, receiving numerous accolades such as Inc. Magazine’s Inc. 500 Award and Nashville Chamber of Commerce Small Business of the Year.