Healthcare Investigations by the Office of Inspector General

As someone working with one or more of the over 100 Health and Human Services programs across the U.S., it’s important that you understand the body that regulates your work. Under the U.S. Department of Health and Human Services, the Office of Inspector General’s mission is to protect the integrity of department’s programs as well as the health and welfare of program beneficiaries.

What do they do?

In order to protect the department’s programs, according to their website, the OIG investigates waste, fraud and abuse by carrying out audits and investigations and by developing and distributing "resources to assist the health care industry in its efforts to comply with the Nation’s fraud and abuse laws and to educate the public about fraudulent schemes so they can protect themselves and report suspicious activity."

Reported statistics

In the Semiannual Report to Congress for the period of October 1, 2017 to March 31, 2018, the OIG reported:

  • Expected investigative recoveries of $1.46 billion
  • Criminal actions against 424 individuals or entities
  • Exclusion of 1,588 individuals and entities from Federal healthcare programs
  • Civil actions against 349 individuals or entities

Employees rights

Employees without grounds for asserting their Fifth Amendment rights are required to cooperate fully with investigators. If you have a reason to be concerned, you should immediately contact a lawyer who specializes in health care law.

If you feel that you could be under investigation, it’s critically important that you understand your rights and retain counsel immediately.

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