HHS Announces Operation Restore Trust Expansion
The federal government is serious about stemming health care fraud and abuse. Key federal agencies are determined to show that they can save money, and now say they have the resources they need to do the job.
Consider:
- The FBI's financial crimes unit has increased its number of medical industry investigators from 290 last year to 350 today. Together they are handling some 2,300 cases.
- The Internal Revenue Service now has 160 employees in its 3,200-member criminal division who are dedicated to health care fraud cases -- double the number it had just three years ago.
- The Justice Department is currently in the process of doubling its health care fraud prosecutors by hiring 115 new attorneys.
Not only is the government devoting bodies to the effort, it is backing them up with the funds they need as well. The 1996 Kennedy-Kassebaum bill greatly increased funding for Medicare anti-fraud crime fighters by letting them tap into the Medicare Trust Fund for the first time. They got $104 million in 1997, and that figure will increase to more than $200 million a year by 2002.
If you have seen evidence of Medicare fraud or abuse, please call the Health and Human Services fraud hotline: 1-800-447-8477.
The Office of the Inspector General Drafts Model Compliance Plan for Hospitals
November 15, 1997
The Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) is planning to issue a Model Compliance Plan for Hospitals toward the end of the year. We have obtained an advance copy of the current draft of this Compliance Plan which indicates that the OIG is strongly encouraging all health care organizations to adopt compliance programs. While the compliance programs remain voluntary, the OIG asserts that they have "become a necessary element to manage the various departments and divisions of health care organizations." The OIG notes that implementing a Model Compliance Plan is an evolving process that is applicable to all types of hospitals, from small, rural non-profits to corporate owned major hospital chains. The plan can be tailored to fit individual provider needs and financial realities but simply developing the plan is not enough; implementation is essential. The OIG also emphasizes throughout the document that nothing in the Model Compliance Plan should substitute for legal advice from experienced counsel when appropriate because of the hospital's potential exposure.