Which organization fights waste, fraud, and abuse in Medicare and Medicaid?

• A. Office of Inspector General (OIG)
• B. Centers for Medicare and Medicaid Services (CMS)
• C. Department of Health and Human Services (HHS)
• D. Government Accountability Office (GAO)

Answer: (A)

Fighting waste, fraud, and abuse in Medicare and Medicaid is handled by the Office of Inspector General. This entity, part of the Department of Health and Human Services, is responsible for detecting improper payments and wrongdoing in HHS programs, conducting audits and investigations, and referring cases to the Department of Justice for criminal prosecutions or civil actions. It also can impose exclusions to keep fraudulent providers from federal programs. While the Centers for Medicare and Medicaid Services runs the programs, and GAO serves as a congressional watchdog, the OIG is the specific body focused on program integrity and enforcement within Medicare and Medicaid.