Testimony Before the United States House of Representatives Committee on Ways and Means Subcommittee on Oversight**
Health Care Fraud Investigations
Testimony of: Abhijit Dixit, Special Agent, Office of Investigations, Office of Inspector General, Department of Health and Human Services
“The monetary penalties for noncompliance with the OIG’s prohibition on payments to excluded individuals or entities can be significant. The average fine for hiring or contracting with an excluded person or entity is over $100,000.
The work of OIG’s special agents has a valuable and positive impact across the country. During fiscal years 2013 through 2015, OIG investigations nationally resulted in more than $10.9 billion in investigative receivables, or dollars ordered or agreed to be paid to Government programs as a result of criminal, civil, or administrative judgments or settlements. In addition, our investigations led to 2,856 criminal actions, 1,447 civil actions, and 11,343 program exclusions. Beyond these statistical accomplishments, OIG special agents are on the front lines, interacting daily with Medicare and Medicaid beneficiaries and providers. Though difficult to quantify, a valuable part of our work is protecting beneficiaries from harm
“OIG has the authority to exclude individuals and entities from federally funded health care programs. The effect of an exclusion is that no payment will be made by any Federal health care program for any items or services furnished, ordered or prescribed by an excluded individual or entity.”