OIG Investigations – ROI?

January 31, 2009

On January 16, the Department of Health and Human Services Office of Inspector General released its Annual Performance Report for 2008. One of the measures on which the OIG reports is the return on investment for expenditures related to the Medicare and Medicaid programs. According to the report, OIG recovered $17 for every dollar spent over the three year period from 2006 through 2008.

OIG calculates its ROI figures using a three-year average to account for how long it takes for an audit, evaluation, or investigation to be resolved and for the funds to be recovered. OIG has steadily improved its ROI, having reported $11.60 for 2005, $14.40 in 2006, and $16.40 in 2007.

The Annual Performance Report also lists the number of complaints received by the OIG for investigation. That number has shot up from 3,774 in 2005 to 4,832 in 2008. There has been a corresponding increase in the number of new cases opened by the OIG, from 1,660 in 2005 to 2,121 in 2008.

In short, the OIG has been getting busier over the last few years, and that increased activity apparently has led in an improved return on investment. There aren’t many ways the government can spend money to make money, and it’s a safe bet the OIG’s ROI numbers will mean a greater financial investment in healthcare enforcement activity. Therefore, we can expect more agents hired, cases opened, and subpoenas served in 2009. That leads us back to where we started: trying to figure out the types of cases the government will pursue, and thus the areas on which providers should focus their compliance efforts.

To review the annual report, click here:


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