The Office of Inspector General (OIG) for the U.S. Department of Health and Human Services reported $5.56 billion in expected recoveries and projected savings over a six-month period and said it had excluded 1,212 individuals and organizations from federal health programs, according to a semiannual report delivered to Congress.
The report, covering the six months from October through March, shows the OIG returned $12.70 for every dollar it spent during that window. The headline dollar figure was heavily influenced by several large enforcement outcomes, including a 15-year prison sentence handed down to a telemedicine software executive involved in a $1 billion scheme, and $674 million in settlements with affiliates of Kaiser Permanente and with CVS Health’s Aetna division related to allegedly inflated Medicare Advantage billing.
Declining enforcement activity
Despite the sizable monetary totals, the OIG’s caseload declined. Combined criminal and civil actions fell to 604 in the reporting period, down from 833 in the prior period and the lowest total recorded in at least two years. Criminal referrals also decreased, dropping to 1,168 from 1,451 previously. The number of individuals or entities excluded from Medicare-related programs was 1,212, continuing a two-year decline from 1,795.
The report states that enforcement levels show no acceleration compared with the comparable period under the prior administration; casework was essentially flat and then fell.
Change in how monetary results are scored
The OIG said its prominent "total monetary impact" metric, which combines actual recoveries with projected savings, was introduced in early 2025. That measure has shown substantial volatility, moving from $16.61 billion to $2.43 billion and now to $5.56 billion. The report’s glossary cautions that these figures reflect amounts ordered or agreed to be repaid, not money actually collected.
This methodological shift complicates direct comparisons of headline figures across reporting periods and highlights the difference between court-ordered or negotiated repayments and actual collections.
Coordination with new White House task force and political context
The OIG noted that it now coordinates with a White House fraud task force led by Vice President JD Vance. The report appears as senior administration officials, including the Vice President, HHS Secretary Robert F. Kennedy Jr., and Medicare chief Mehmet Oz, publicly press what the White House describes as an "unrelenting" campaign against health-care fraud.
Separately, the report does not contain a $2 billion figure that Mehmet Oz has said represents improper spending on people in the country illegally; the OIG report does not include that amount.
Geographic and program findings
Audits in the report uncovered unallowable payments for deceased enrollees spanning 35 states plus Puerto Rico and Washington, D.C., indicating that improperly made payments were geographically widespread rather than concentrated in a few jurisdictions.
Autism-related services drew particular scrutiny. In audits covering Indiana, Wisconsin, Maine, and Colorado, the OIG flagged hundreds of millions of dollars in improper or potentially improper Medicaid payments tied to applied behavior analysis therapy. The OIG attributed these findings to administrative shortcomings: missing documentation, unsigned assessments, copied session notes, staff lacking proper credentials, and weak oversight at the state level.
The four audits did not allege the existence of a criminal conspiracy, though the OIG said its findings do not preclude the possibility that other agencies could pursue criminal matters arising from the same facts.
Leadership and report provenance
This semiannual report is the first full accounting signed by Inspector General T. March Bell. Confirmed by the Senate in December, Bell is a long-time Republican attorney who previously led a House investigation of Planned Parenthood and served as chief of staff in the HHS Office for Civil Rights during the first Trump administration.
Overall, the OIG’s six-month accounting presents a mixed picture: substantial headline dollar outcomes driven by a small number of large matters, offset by a falling volume of overall enforcement actions and a change in the office’s methodology for reporting monetary impact.