What government agency investigates Medicare/Medicaid fraud?

The Office of the Inspector General (OIG) is the agency responsible for investigating Medicare and Medicaid fraud. The OIG operates within the Department of Health and Human Services (HHS) and is specifically tasked with protecting the integrity of these programs and the health and well-being of beneficiaries. This includes identifying and investigating fraudulent activities, overseeing the administration of HHS programs, and enforcing compliance with health care laws and regulations.

The OIG conducts audits and investigations to detect fraud, waste, and abuse in the Medicare and Medicaid systems, which are significant programs that provide health care coverage to millions of Americans. The agency also works to ensure the financial integrity of these programs and to improve their efficiency and effectiveness.

While other agencies, such as the Department of Health and Human Services, play a role in overseeing the broader health care system and potentially addressing health policy matters, the OIG specifically has the mandate for investigating fraudulent activities within Medicare and Medicaid. The FBI may also investigate health care fraud cases, but they typically do so in partnership with the OIG and after OIG has identified potential criminal violations.