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The Office of Inspector General (OIG) for the United States Department of Health and Human Services (HHS) is charged with identifying and combating waste, fraud, and abuse in the HHS’s more than 300 programs, including Medicare and programs conducted by agencies within HHS, such as the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health. Since 2004, Daniel R. Levinson has served as HHS’s Inspector General, a presidentially appointed, nonpartisan position.
The mission of the OIG as mandated by the Inspector General Act (Public Law 95-452, as amended), is to protect the integrity of HHS’s programs as well as the well-being of the beneficiaries of those programs.
OIG holds accountable those who bill HHS programs but do not meet Federal health program requirements or who violate Federal laws regarding the use of Federal health care funds. OIG also identifies opportunities to improve the economy, efficiency, and effectiveness of HHS programs.
OIG reports both to the Secretary of HHS and to the United States Congress about program and management problems and recommendations to correct them. OIG's work is carried out by regional offices nationwide that perform audits, investigations, inspections and other mission-related functions.
HHS OIG is the largest inspector general's office in the Federal Government, with more than 1,700 employees dedicated to combating fraud, waste and abuse and to improving the efficiency of HHS programs. Most of OIG's resources go to overseeing Medicare and Medicaid — programs that represent much of the Federal budget and affect the most vulnerable U.S. citizens. OIG's oversight extends to programs under other HHS institutions, including the Centers for Disease Control and Prevention, National Institutes of Health, and the Food and Drug Administration.
The OIG consists of the following six components:
The Office of Investigations (OI) conducts criminal, civil and administrative investigations of allegations of wrongdoing regarding HHS programs or HHS beneficiaries. Investigative efforts lead to criminal convictions, civil judgments and settlements, administrative sanctions, and/or civil monetary penalties. Additionally, a small Protective Operations Branch (POB) within OI consists of special agents dedicated solely to protection of the Secretary of HHS in support of domestic and overseas missions.
The Office of Audit Services (OAS) provides all auditing services for HHS, either through its own resources or by overseeing audit work of others. Audits examine the performance of HHS programs and/or its grantees and contractors in carrying out their respective responsibilities and provide independent assessments of HHS programs and operations.
The Office of Evaluation and Inspections (OEI) conducts management and program evaluations that focus on issues of concern to HHS, the Congress and the public. OEI generally focuses on identifying instances in which the management of large HHS programs can be improved to increase the well-being of beneficiaries or to save Federal health care dollars.
The Office of Counsel to the Inspector General (OCIG) represents OIG in all civil and administrative fraud cases and, in connection with these cases, negotiates and monitors corporate integrity agreements, a compliance agreement in which health care providers or other entities consent to a set of obligations in order to avoid being excluded from participating in any Federal health care program. OCIG also provides guidance to the health care industry to promote compliance with Federal laws and regulations and provides legal support to OIG operations.
The Immediate Office, which includes the Office of External Affairs which handles OIG’s interactions with Congress and the public, is directed by the Inspector General with the assistance of the Principal Deputy Inspector General and his staff.
The Office of Management and Policy provides mission-support services to the Immediate Office of the Inspector General and other OIG components.
The Health Care Fraud Prevention and Enforcement Action Team (HEAT) is a joint task force between OIG, other HHS agencies, and the U.S. Department of Justice (DOJ). Established by President Barack Obama in May 2009, HEAT Strike Force teams target fraud "hot spots" in cities across the country to identify and arrest perpetrators of health care fraud and develop new cutting-edge approaches to combat health care fraud. Under the HEAT initiative, Strike Force teams composed of Special Agents from OIG, DOJ prosecutors, the Federal Bureau of Investigation agents and, in some cases, State and local law enforcement agents collaborate to arrest and convict individuals and entities charged with health care fraud.
HHS-OIG agents qualify with, and field the Glock 23 and Glock 27 pistols as well as the LWRC M6 rifle on a quarterly basis. Agents conduct regular refresher training in law enforcement defensive and arrest tactics.