Nov. 21—The federal government’s lead healthcare anti-fraud enforcer plans a greater focus in coming years on promoting “a high-performing healthcare system” that improves outcomes and lowers costs, with safeguards that protect new and changing systems and programs from fraud, waste, and abuse.

The U.S. Health and Human Services Department’s Office of Inspector General (OIG) issued a five-year plan this week of future enforcement priorities. The OIG’s enforcement of previous efforts resulted in estimated savings and expected recoveries of $15.4 billion in “misspent funds” in FY12, according to Daniel Levinson, inspector general. 

“As HHS manages the transition to payments based on value rather than volume, we plan to conduct reviews and recommend changes to maximize overall value, protect program integrity, and foster value and high performance,” the report stated.

In addition to OIG’s continued anti-fraud efforts, the office plans a greater push to promote quality of care in areas such as nursing facilities and home- and community-based settings. The office also will encourage more preventive care access and use, as well as more quality improvement programs.

Publication Date: Thursday, November 21, 2013