Layoffs, budget cuts hamper Medicare anti-fraud efforts

While Medicare fraud fighting efforts already have taken a big hit thanks to a combination of layoffs and budgetary issues at the U.S. Department of Health & Human Services Office of Inspector General, more cuts almost assuredly are looming, according to a report from the Center for Public Integrity.

OIG Deputy Inspector General Gary Cantrell, at a hearing of the Senate Committee on Homeland Security and Governmental Affairs last week, testified that 400 more staffers are set to be cut over the next two years. He also said that 1,200 complaints of alleged "wrongdoing" in the last year alone were "closed down" over a lack of financial resources.

"We're operating with a reduced budget in the face of a growing program," Cantrell said. "Those are complaints that came through the door that we didn't have the resources to investigate further to determine whether it was a viable criminal case or not. And that number doesn't appear to be going down."

According to CPI, OIG officials haven't confirm that they will scale back any programs, but the layoffs will likely impact efforts geared toward weeding out fraudulent use of electronic health records. Just last fall, OIG made clear its intention to combat EHR fraud in its 2013 work plan.

In April, six Republican senators called for a reboot of the Meaningful Use incentive program, citing the potential for waste and abuse as one of many reasons the program was failing.

Last month, CMS announced that $14.9 billion has been recouped as a result of bolstered Medicare fraud efforts under the Affordable Care Act. The agency said that close to 15,000 crooked providers and suppliers had been thrown out of the Medicare program over the past two years.

To learn more:
- read the Center for Public Integrity article