OPM Seal U.S. Office of Personnel Management

FY 2000
Budget Justification/Performance Plan

(Advances and Reimbursements - continued)
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OIG Goal 3: Fraud against OPM programs is detected and prevented.
Means Blue Arrow Head  Promote and protect the integrity of the Federal Employees Health Benefits Program through debarment of untrustworthy health care providers.
Blue Arrow Head  Target program weaknesses and develop new techniques for detecting fraud.
Blue Arrow Head  Conduct objective, aggressive, thorough, and timely audits, investigations, and evaluations.
Blue Arrow Head  Pursue restitution, whenever possible.
Blue Arrow Head  Publicize offender convictions for deterrent effect.
Blue Arrow Head  Work with program managers and legislators to improve the legal tools needed to protect OPM programs from fraud, other illegal acts or abuse.
Blue Arrow Head  Utilize the Program Fraud Civil Remedies Act (31 U.S.C. 3801-3812) by investigating program fraud allegations involving false claims of up to $150,000 and report findings and conclusions to the General Counsel, the agency reviewing officer.
Blue Arrow Head  Maintain investigative hotlines as a means of receiving information regarding fraud against OPM programs.
    
Indicators/Performance Results Blue Arrow Head   Number of investigations resulting in a positive disposition for the agency.

Investigative efforts in FY 1998 resulted in 22 arrests. These arrests primarily involved civil service retirement fraud. Accomplishment also applicable to OIG Goal 2.
Blue Arrow Head   Number of debarments and amount of fines.

The number of common rule debarments issued against health care providers whose actions indicated that they presented a threat to the integrity of the FEHBP rose from 1886 in FY 1997 to 2926 in FY 1998. This represents a 55 percent increase, which is attributable principally to the expanding overall level of attention being paid to health care fraud issues on a Governmentwide basis. Accomplishment also applicable to OIG Goal 1 and OIG Goal 2.  No fines were imposed during FY 1998.
Blue Arrow Head  Number of referrals to the DOJ.

In FY 1998, there were 113 referrals to DOJ.
Blue Arrow Head  Percentage of carriers in compliance with debarment guidelines, and the percent that have a debarment implementation plan in place.

In FY 1998, 100% of carriers have an implementation plan in place.
Blue Arrow Head  Percentage of debarments and contested proposed debarments processed within established time requirements.

Under common rule debarments, 100% processed within time requirements in FY 1998.

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Web Page Created 14 May 1999