Following President Barack Obama's $4.1 trillion dollar budget proposal for fiscal year 2017, the Office of Inspector General (OIG) has requested more than $419 million to fight fraud, waste and abuse within federal healthcare programs.
The OIG's Congressional Budget Justification outlines a $77 million increase from the previous year, including an additional $68 million devoted to Medicare and Medicaid oversight. The $334 million that would go toward controlling fraud, waste and abuse within the two programs includes $200 million in mandatory funding for the Health Care Fraud and Abuse Control (HCFAC) program and $121 million in discretionary funds.
The OIG is also asking for $85 million to oversee public health and human services programs, including the Affordable Care Act marketplaces.
"OIG's oversight work in FY 2017 will target fraud and wasteful spending, including improper payments, unsafe or poor quality healthcare and security of data and technology," the report states. "OIG is a leader in the fight against Medicare and Medicaid fraud and we will continue to use sophisticated data analytics and state-of-the-art investigative techniques to detect and investigate fraud, including the rising level of prescription drug fraud and associated patient harm."
In FY 2016, the OIG requested nearly $405 million, but was allocated $342.5 million. This year, the agency highlighted $2.2 billion in investigative receivables expected in 2015, and noted the HCFAC's return on investment averaged $7.5 for every $1 spent between 2010 and 2014.
Obama's proposed budget for FY 2017 featured seven fraud, waste and abuse policies that would save $3.4 billion over the next decade, including restructuring the Recovery Audit Contractor program, and requiring prior authorization for power mobility devices and advanced imaging. Researchers have previously expressed concern over expanding Medicare and Medicaid budgets that have become unmanageable, leading to rampant fraud within the healthcare system. The OIG continues to focus on Medicare Part D fraud, particularly after seeing a high spike in drug payments linked to commonly abused opioids.
To learn more:
- read the OIG report
Obama's 2017 budget proposal includes provisions to combat fraud
OIG's 2016 Work Plan targets Part D, med equipment fraud concerns
Rampant healthcare fraud result of unmanageable federal spending, report says
OIG reports revisit questionable billing and fraud within Medicare Part D