The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) said in its latest semiannual report to Congress that it generated $5.56 billion in expected recoveries and savings over a six-month period.
The OIG said in the report, covering the period from October 2025 through March 2026, that the total includes $4.3 billion in investigative receivables, $814.1 million in audit and evaluation receivables, and $447.6 million in potential cost savings.
The report’s glossary defines audit and evaluation receivables as monies that an entity audited by the OIG has agreed should not be charged to the government.
Investigative receivables are amounts ordered or agreed to be repaid to federal or state entities following OIG investigations that resulted in criminal actions, civil and administrative settlements, civil judgments, or administrative actions. The figures do not represent actual collections, it stated.
Potential cost savings are funds that the OIG deemed could be “put to better use” if the Department of Health and Human Services implements its recommendations, according to the glossary.
The federal health watchdog generated the amounts through enforcement actions across all aspects of the healthcare system, which had led to the exclusion of 1,212 individuals from federal healthcare programs. The OIG said it returned $12.70 to the federal government for every dollar spent.
Inspector General Thomas March Bell, who signed the report, noted the federal watchdog’s commitment to pursuing fraudsters who exploit federal healthcare programs designed to support low-income families and people with disabilities.
“OIG is determined to hold bad actors accountable,” Bell said. “Notable actions include convictions of individuals running sham hospices, identification of improper payments and vulnerabilities in emerging risk areas such as Medicaid payments for autism services, and uncovering gaps in foster care systems that contributed to failures to track and find missing children.”
Among the enforcement actions highlighted in the report was the case of a healthcare software company CEO who was sentenced to 15 years in prison last year and ordered to pay $452 million in restitution after being convicted of conspiracy to orchestrate a $1 billion telemedicine and durable medical equipment fraud scheme.
The OIG said its investigations into fraud, waste, abuse, and mismanagement in federal healthcare programs stem from tips submitted through its hotline. During the six-month reporting period, the federal health watchdog evaluated more than 40,800 tips.
The report showed no surge in enforcement actions compared with the comparable period under the former administration. Combined criminal and civil actions fell to 604, down from 833 in the prior period.
