HHS investigative unit set to lose hundreds of staff

Pia Christensen

About Pia Christensen

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Despite the Obama administration’s focus on cutting health care costs and fraud in the Medicare and Medicaid systems, the office charged with investigating such things plans to cut 400 staffers by the end of 2015.

Fred Schulte at The Center for Public Integrity reports that the news came to light during a June 24 congressional hearing about prescription drug abuse in Medicare.

The Department of Health and Human Services’ Office of Inspector General  is responsible for investigating fraud and abuse in the system. Last year the office shut down investigations into 1,200 complaints because of a lack of resources, according to Gary Cantrell, deputy inspector general for the OIG Office of Investigations.

Cantrell blames the cuts on “a mix of budgetary issues which he called ‘expiring funding streams.’” Schulte reports that no one at HHS would discuss the situation.

Schulte has previously reported on electronic health records and linked them to higher health care costs. He points out one potential impact of the cuts:

One major project that’s likely to be scaled back is an ambitious plan to “identify fraud and abuse vulnerabilities” in electronic health records. The federal government is spending about $36 billion in economic stimulus funds to help doctors and hospitals purchase the digital technology in the hopes that it will ultimately reduce waste from duplicative tests and make health care more efficient and less costly.

The OIG’s 2013 Work Plan outlines the office’s focus and new and ongoing projects, including reasonableness of Medicare payments, coding of medical equipment claims, questionable billing patterns, review of claims submitted by “error-prone” providers and more. Meanwhile, ProPublica, the Center for Public Integrity, The Wall Street Journal and other publications have documented fraudulent and wasteful practices in Medicare.

Leave a Reply