POGO - A Department of Health and Human Services (HHS) plan to cut purported waste by slashing oversight staff could enable far more waste, fraud, and abuse, insiders told the Project On Government Oversight (POGO). They stressed that the costs of such a move could fall largely on taxpayers.
Earlier this year, HHS announced a plan to close six offices overseeing the legal implementation of two of the most expensive government programs: Medicare and Medicaid. The planned cuts are a case study in how an effort to slash government spending could instead enable waste and other problems. These teams help HHS conduct oversight by focusing on cases that involve misspent federal dollars, and they provide legal support when the federal government steps in to protect patients from abusive or negligent practices like substandard conditions in nursing homes or the theft of controlled substances.
At $2.86 trillion for fiscal year 2024, HHS’s budget is one of the largest in the federal government, representing more than a fifth of the federal budget. More than 90% of the resources allocated to the department in fiscal year 2024 went to the Centers for Medicare and Medicaid Services (CMS).
The agency’s Office of the General Counsel (OGC) plays a key oversight role within the department. It currently has 10 regional offices across the nation, which ensure that providers comply with Medicare and Medicaid regulations, and that money is spent on patients — not diverted by fraud or waste.
The work of OGC offices touches hospitals, nursing homes, and rural and tribal healthcare facilities, and it can range from recovering millions owed to Medicare and Medicaid when a facility goes into bankruptcy, to overseeing compliance with healthcare regulation, to supporting in administrative and judicial litigation when facilities or providers are accused of abuse or negligence.
More than half of HHS OGC offices are slated to be closed this fall.
“If you cut all of the people who are responsible for administering the programs, what happens to the programs?” asked one HHS attorney, who spoke with POGO under an agreement not to publish their name due to fear of reprisal.
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