The federal watchdog for the Department of Health and Human Services (HHS) has projected it will recover or save $5.56 billion over six months — a tidy sum, even if the number of enforcement actions has slipped to a two-year low.

The HHS Office of Inspector General (OIG) released its semiannual report Monday, covering October through March. According to Reuters, the agency says it generated $12.70 in recoveries and expected savings for every dollar it spent. Not a bad return.

A few big cases drove the total. A telemedicine software executive got a 15-year prison sentence tied to a $1 billion fraud scheme. And affiliates of Kaiser Permanente and CVS Health Corp (CVS)'s Aetna agreed to pay $674 million to settle allegations that they inflated Medicare Advantage billing.

The OIG also barred 1,212 individuals and companies from participating in federal programs. But here's the catch: enforcement activity has hit a two-year low. Criminal referrals fell to 1,168 from 1,451 in the prior period.

The report is the first comprehensive assessment under Inspector General T. March Bell, a Republican lawyer confirmed by the Senate in December. Bell previously led a House investigation into Planned Parenthood.

The report's "total monetary impact" — a metric introduced in early 2025 — has been all over the map. It dropped from $16.61 billion to $2.43 billion before bouncing back to $5.56 billion. The OIG notes these figures reflect ordered or agreed repayments and projected savings, not actual cash recovered.

Medicaid Fraud Crackdown Grows

The health department has been zeroing in on Medicaid fraud. In April, CMS Administrator Mehmet Oz announced a nationwide crackdown, ordering all 50 states to submit provider revalidation plans within 30 days or face intensified federal audits.

In June, the Justice Department sued New York state officials and Public Partnerships LLC, accusing them of facilitating fraud in a $10 billion Medicaid home-care program for disabled patients.

The Supreme Court also weighed in, rejecting a Medicaid fraud appeal from Eli Lilly and Co. (LLY) in May. The drugmaker argued that the False Claims Act wrongly lets private whistleblowers sue on the government's behalf for a share of recoveries. In fiscal 2024, whistleblowers filed a record 979 False Claims Act cases, leading to more than $2.9 billion in settlements and judgments, according to the DOJ.