Which office is primarily responsible for investigating health care fraud, waste, and abuse?

The Office of Inspector General (OIG) is primarily responsible for investigating health care fraud, waste, and abuse. The OIG operates under the Department of Health and Human Services (HHS) and is dedicated to protecting the integrity of federal health care programs, such as Medicare and Medicaid. It investigates issues like fraud and abuse within these programs and works to protect both the beneficiaries and the taxpayers. Furthermore, the OIG conducts audits, evaluations, and investigations, providing oversight and enforcing compliance in health care facilities.

This role is distinct from other agencies; for example, while the Centers for Medicare & Medicaid Services (CMS) plays a significant role in administering those programs and ensuring compliance with regulations, its focus is more on the operational aspects rather than investigating fraud directly. Similarly, the Department of Justice (DOJ) handles prosecution of criminal cases related to health care fraud but does not conduct the initial investigations, which falls under the jurisdiction of the OIG. While the HHS encompasses a broader range of health services and programs, the OIG specifically focuses on preventing and addressing fraud, waste, and abuse within these areas. Thus, the OIG's unique mission and authority make it the primary agency for investigating these issues.