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    Wednesday, September 23, 2009


    The Department of Health and Human Services (HHS) Office of Inspector General (OIG) expects to recover more than $2.4 billion in the first half of fiscal year (FY) 2009, the agency said in its Semi-Annual Report to Congress.According to the June 8 report, OIG’s expected recoveries include $274.8 million in audit-related receivables and $2.2 billion in investigative-related receivables, which includes nearly $552 million in non-HHS receivables resulting from OIG work.

    Between October 2008 and March 2009, OIG reported exclusions of 1,415 individuals and organizations for fraud or abuse involving federal health care programs and/or their beneficiaries; 775 criminal actions against individuals or organizations that engaged in crimes against HHS programs; and 342 civil actions, which include False Claims Act and unjust enrichment suits, Civil Monetary Penalties Law settlements, and administrative recoveries related to provider self-disclosure matters.

    The report also noted that OIG investigators and attorneys were instrumental in the government’s $1.4 billion settlement with Eli Lilly and Company. Lilly agreed to plead guilty to promoting its anti psychotic drug Zyprexa for uses not approved by the Food and Drug Administration and not covered by Medicaid or other federal programs.

    Another OIG investigation resulted in an over $97.5 million settlement with Bayer HealthCare LLC, the report said. That settlement related to allegations that Bayer paid kickbacks to several durable medical equipment mail order suppliers and diabetic supply distributors, leading them to submit false claims to Medicare.

    “These recoveries reflect our dedicated efforts to reduce fraud, waste, and abuse in HHS programs,” Inspector General Daniel R. Levinson said in a press release announcing the report. “We will continue to employ all of our audit, evaluation, investigation, and legal tools and also to collaborate with OIG’s government partners to accomplish this vital and expanding mission.”

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