Legal
OIG Reports FY2025 Health Care Fraud Control Program Recoveries
HHS OIG released its annual Health Care Fraud and Abuse Control Program fact sheet for fiscal year 2025, summarizing enforcement results including criminal and civil actions, exclusions, and monetary recoveries from fraud investigations across Medicare and Medicaid. The report covers joint efforts by HHS, OIG, and the Department of Justice to combat health care fraud and recover improperly billed funds. It reflects activity completed during FY2025, which ended September 30, 2025. State Medicaid agencies, managed care organizations, and providers participating in federal health programs are affected by the enforcement trends and priorities the report highlights.
Why it mattersMedicaid agencies and MCOs rely on this annual accounting to gauge federal enforcement priorities and recovery trends that shape program integrity audits and provider compliance risk.