OIG’s system to prevent repeat billing fraud is broken: Report

The HHS’ Office of Inspector General keeps a list of more than 14,000 individuals barred from receiving federal healthcare dollars, but does little to track what these individuals do after being banned, Kaiser Health News reported Dec. 12. 

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At large health systems, hires are usually vetted to ensure they have not violated billing laws, the outlet reported, but people who own or operate healthcare businesses are usually not subject to the same background checks. 

In a sample of 300 healthcare business owners and executives on OIG’s exclusion list, KHN found eight people who were serving in roles that could violate their bans, and six who transferred control of their business to a family member after being banned from receiving federal dollars. 

In the sample, KHN also found nine people who had previous felony or fraud convictions and went on to commit healthcare fraud, and seven who were repeat violators of billing laws. 

Regulators do not actively search for repeat offenders on the OIG’s exclusion list, KHN reported. 

Read the full investigation here.

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