What Does the HHS OIG Investigate?

The Health and Human Services Inspector General’s primary mission is the protection and integrity of (HHS) the U.S. healthcare system as well as combating Health Care Fraud in HHS programs such as Medicare and Medicaid and the health and welfare of program beneficiaries. HHS conducts criminal, civil and administrative investigations of fraud and misconduct related to HHS programs, operations, and its beneficiaries.  

The HHS OIG Investigates 

• Charging excessive billings on services and supplies
• Knowingly submitting false statements
• Misrepresentation on Medicare claims
• Conducting prohibited solicitations and accepting payments for services reimbursed by the health programs of the federal government
• Making prohibited referrals and accepting payments higher than what is allowed under the program

What is the Authority of the HHS OIG

The HHS Office of the Inspector General maintains field offices across the U.S staffed with federal investigators are known as Special Agents to investigate fraud, waste, and abuse by Doctors, Nurses, Pharmacies, Insurance companies, and other healthcare-related professionals. HHS OIG Special Agents are authorized to carry firearms and make arrests.

Medicaid Fraud Control Units (MFCUs) investigate and assist in the prosecution of Medicaid provider fraud in US District Court as well as patient abuse or neglect in health care facilities and board and care facilities. MFCUs operate in 50 States.

HHS OIG Medicare Strike Force teams operate in  Miami, Florida; Los Angeles, California; Detroit, Michigan; Houston, Texas; Brooklyn, New York; Baton Rouge and New Orleans, Louisiana; Tampa and Orlando, Florida; Chicago, Illinois; Dallas, Texas; Washington, D.C.; Newark, New Jersey/Philadelphia, Pennsylvania; and the Appalachian Region and have shut down health care fraud schemes around the country, arrested more than a thousand criminals, and recovered millions of taxpayer dollars.