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NCJ Number: 67356 Add to Shopping cart Find in a Library
Title: US DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE - OFFICE OF INSPECTOR GENERAL - ANNUAL REPORT, APRIL-DECEMBER 1977 (FROM LEGISLATION TO ESTABLISH OFFICES OF INSPECTOR GENERAL - HR 8588, 1978 - SEE NCJ-67352)
Author(s): ANON
Corporate Author: US Congress
Senate Cmtte on Governmental Affairs
United States of America
Date Published: 1978
Page Count: 74
Sponsoring Agency: US Congress
Washington, DC 20510
Type: Legislative/Regulatory Material
Format: Document
Language: English
Country: United States of America
Annotation: THIS 1977 ANNUAL REPORT OF THE INSPECTOR GENERAL'S OFFICE IN THE DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE (HEW) COVERS THE OFFICE'S ACTIVITIES DURING ITS FIRST 9 MONTHS OF OPERATION.
Abstract: AN INVENTORY OF BEST ESTIMATES OF FRAUD, ABUSE, AND WASTE IN HEW PROGRAMS INDICATED LOSSES OF $6.3 BILLION TO $7.4 BILLION ANNUALLY, OR 4.7 TO 5.4 PERCENT OF THE FEDERAL OUTLAYS CONCERNED. THE LARGEST SOURCE OF LOSSES PROBLEM IS THAT OVER 51,000 HEW ENTITIES MUST BE AUDITED. EXAMINATIONS OF CURRENT CRIMINAL INVESTIGATIONS AND CONVICTIONS OF THOSE WHO DEFRAUD HEW PROGRAMS SHOWED A CURRENT CASELOAD OF 1,349 AND A TOTAL OF 265 CONVICTIONS. AN AVERAGE OF 2.5 MONTHS PASSED BETWEEN REFERRAL AND INDICTMENT. PROJECT INTEGRITY, WHICH INVESTIGATED FRAUD AND ABUSE BY PHYSICIANS AND PHARMACISTS, HAS REVEALED 535 POTENTIAL FRAUD CASES. IN WELFARE, PROJECT MATCH HAS SYSTEMATICALLY IDENTIFIED AND REVIEWED WELFARE RECIPIENTS FOR ELIGIBILITY. THE VARIOUS STUDENT FINANCIAL ASSISTANCE PROGRAMS HAVE BEEN REORGANIZED AND STUDENT LOAN DEFAULTS INVESTIGATED. THE INSPECTOR GENERAL'S OFFICE HAS ALSO FOCUSED ON EMPLOYEE CONDUCT AND CONFLICT OF INTEREST CASES AND SERVICE DELIVERY ASSESSMENT. AMONG RECOMMENDATIONS ARE THAT (1) THE INSPECTOR GENERAL'S OFFICE CONDUCT PERIODIC INVENTORIES OF ESTIMATES OF FRAUD, WASTE, AND ABUSE; (2) TIGHTER CONTROLS OVER ELIGIBILITY DETERMINATION AND CLAIMS PAYMENT BE INSTITUTED; (3) THE INSPECTOR GENERAL'S OFFICE GRADUALLY TAKE OVER INVESTIGATION OF MEDICARE AND MEDICAID FRAUD; AND (4) PROJECT MATCH BE EXPANDED AND CONTINUED. FIGURES AND TABLES ARE INCLUDED. FOR RELATED MATERIALS PRESENTED AT THE HEARING ON INSPECTOR GENERAL LEGISLATION, SEE NCJ 67353-55 AND 67357-58. (CFW)
Index Term(s): Audits; Financial management; Fraud; Program abuse; Regulations compliance; US Department of Health, Education, and Welfare
To cite this abstract, use the following link:
http://www.ncjrs.gov/App/publications/abstract.aspx?ID=67356

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