NCJ Number
51993
Date Published
1978
Length
117 pages
Annotation
THE EFFORTS OF THE U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE (DHEW) OFFICE OF INSPECTOR GENERAL TO ELIMINATE LOSSES DUE TO FRAUD, ABUSE, WASTE, AND MISMANAGEMENT IN DHEW PROGRAMS ARE DISCUSSED.
Abstract
THE TESTIMONY, WHICH IS PRESENTED BY DHEW'S INSPECTOR GENERAL AND DEPUTY INSPECTOR GENERAL, RECAPS THE FIRST 15 MONTHS OF OPERATION OF THE DHEW OFFICE OF INSPECTOR GENERAL, WHICH WAS CREATED BY CONGRESS IN THE WAKE OF REPORTS OF MISMANAGEMENT IN DHEW'S STUDENT LOAN PROGRAM, MEDICAID FRAUD AND ABUSE, BRIBERY OF DHEW OFFICIALS BY TRADE SCHOOLS SEEKING ACCREDITATION AND BY POTENTAL CONTRACTORS, AND OTHER PROBLEMS. THE WITNESSES HIGHLIGHT THE FINDINGS OF THE INSPECTOR GENERAL'S ANNUAL REPORT FOR 1978; REVIEW THE STATUS OF TWO SPECIAL PROJECTS--AN EFFORT TO UNCOVER MEDICAID ABUSES BY PHYSICIANS AND PHARMACISTS (PROJECT INTEGRITY) AND A CHECK OF THE FEDERAL PAYROLL TO DETECT ABUSES OF WELFARE AND STUDENT AID PROGRAMS (PROJECT MATCH); AND DISCUSS WORKLOADS, BACKLOGS, AND STAFFING IN THE OFFICE OF INSPECTOR GENERAL. SPECIAL ATTENTION IS DIRECTED TO THE FOLLOWING ISSUES: CASES IN WHICH CONDUCT BY DHEW PROGRAM PARTICIPANTS IS WRONG BUT NOT PROSECUTABLE; PROBLEMS WITH MEDICARE AND MEDICAID BILLINGS BY TEACHING HOSPITALS; DHEW'S EFFECTIVENESS IN RECOVERING IMPROPERLY APPLIED FUNDS REVEALED IN AUDITS; THE OFFICE OF INSPECTOR GENERAL'S EXPERIENCE WITH CONFLICTS STEMMING FROM FEDERAL PRIVACY AND FREEDOM OF INFORMATION LAWS; THE OFFICE'S USE OF ITS SUBPOENA POWER; AND THE INSPECTOR GENERAL'S ROLE IN ESTABLISHING MEDICAID ANTIFRAUD UNITS IN THE STATES. SUPPORTING MATERIALS INCLUDE COPIES OF DHEW REGULATIONS, A MEMORANDUM REVISING ESTIMATES OF LOSSES INCURRED BY DHEW PROGRAMS IN FISCAL 1977 AND ESTIMATING THE RECOVERABILITY OF THE LOSSES, AND DHEW'S TARGETS FOR COMBATING FRAUD, ABUSE, AND WASTEFUL PRACTICES IN ITS PROGRAMS.