Semiannual Report to Congress First Half FY2006

Over the last 6 months, OIG conducted a wide range of planned activities, addressed many significant new oversight responsibilities under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), and responded to requests for assistance from the Department and the Inspector General community after the devastating hurricanes in the Gulf region. Balancing all of these activities required coordination between the components within OIG, as well as effective collaboration with the Department, Inspector General community, Federal law enforcement, and State and local entities.

Also for this semiannual period, OIG reported exclusions of 1,540 individuals and entities for fraud or abuse involving Federal health care programs and/or their beneficiaries; 226 criminal actions against individuals or entities that engaged in crimes against departmental programs; and 119 civil actions, which include False Claims Act and unjust enrichment suits filed in district court, Civil Monetary Penalties settlements, and administrative recoveries related to provider self-disclosure matters. The results of selected actions on the following topics are included:

• Serono Settlement
   
• Exclusion of South Beach Community Hospital
   
• Medicare Drug Reimbursement
   
• Deficiencies in 340B Drug Discount Program Oversight
   
• Dual Eligible's Transition: Drug Access Under Prescription Drug Plans Formularies
   
• Series of Inspections on Caseworker Visits for Children in Foster Care
   
• Medicaid Upper-Payment-Limit Calculations in Four States