Rumors swirled earlier this year about whether the OIG would still be aggressively hunting down physician errors to recoup more money. Some people believed the new administration had bigger fish to fry, while others suggested that the OIG would be going after every penny. And if a slew of new OIG report releases are any indication, the agency is working as hard as ever to secure billions from healthcare providers.

According to the OIG’s Spring 2025 report, Potential Cost Savings in Medicare and Medicaid, the government could save approximately $17 billion if Congress takes action following the findings of several new reports.

Check out what the latest OIG report findings say and discover how they could lead to billions in savings for the government.

Risk Adjustment in Medicare Advantage: $6.9 Billion

In some cases, providers billed Medicare Advantage with diagnoses that were only reflected in the patients’ health risk assessments, but not on any other service records. The OIG report noted that such diagnoses would typically warrant follow-up visits, tests, procedures or other services if they were genuine.

Therefore, the OIG suggested that the diagnoses were either on the HRA in error (and the provider was paid too much) or the patient received suboptimal follow-up care for serious illnesses.

Inpatient Hospital Stays: $4.9 Billion

The OIG discovered that hospitals were billing inpatient stays at the highest severity level. This led to the most expensive payments. In fact, the number of visits that were billed at the top severity level rose 20 percent in just five years, leading to a massive increase in hospital payments.

The OIG suggested this caused billions in overpayments, and that more intense oversight should begin taking place when it came to these hospital stays.

Two-Midnight Policy: $2.9 Billion

Under the “two-midnight policy,” inpatient payment is considered to be appropriate if the provider can project that the patient will need to be in the hospital at least two overnights. If not, the provider may want to opt for outpatient care.

The OIG found that the rule did reduce the number of inpatient stays, but hospitals continued billing short inpatient stays and very long outpatient stays, costing the government too much money.

Facility vs. Non-Facility Rate: $1.3 Billion

When hospitals buy private practices and operate them as provider-based facilities, they’re then collecting higher payment rates. But one OIG report discovered that many E/M claims billed for these services could have been paid at a lower rate if they’d been billed as freestanding facilities.

As a result, the OIG recommended that CMS should create changes “to lower costs for both the Medicare program and beneficiaries, by equalizing payments as appropriate between provider-based facilities and freestanding facilities for E/M services.”

Preventing Duplicate Medicaid Managed Care Enrollments: $1 Billion

In some cases, states made capitation payments on behalf of Medicaid patients who were enrolled in two different states’ programs. States are supposed to identify concurrent enrollments so they can prevent duplicate payments, but many haven’t been doing so. The OIG recommended new ways to step up such monitoring.