OPM's Inspector General Referred $1.86M in Fraud in One Quarter
Summary
OPM's Office of Inspector General referred $1,856,784 for judicial or administrative action in the quarter ending June 2026 -- the payload of health care fraud investigations that include a provider billing up to 50 hours of psychotherapy in a single day and a transnational scheme that cost the federal health plan $28.24 million.
View data as table
| Transnational DME scheme | $28.24M | FEHBP-carrier cost; ~$12B to all victims |
|---|---|---|
| "Impossible days" psychotherapy | $2.17M | up to 50 hours of therapy billed in a day |
| Lab: unnecessary testing as COVID | $1.34M | indicted June 22, 2026 |
| Lab: duplicative COVID testing | $1.21M | superseding indictment June 18, 2026 |
| Hearing-aid claims | $962,725 | $962,500 restitution agreed |
| COVID billing + fabricated records | $775,883 | guilty plea April 17, 2026 |
| Wound-care / CGM / brace DME | $631,887 | extradition from Cyprus via Turkiye |
| Amniotic membrane grafts | $338,155 | tentative $6.97M restitution to all victims |
| Qui tam copay-waiver | $46,618 | FEHBP exposure; $11,740 recovered |
From local clinics to a $12 billion network
The quarter's health care caseload runs the full range. One medical practice billed for COVID-19 testing and services never provided, then fabricated medical records when carriers asked for proof -- $775,883 in claims. At the other end, linked one case to a transnational durable-medical-equipment scheme that had cost FEHBP carriers $28.24 million and all victims roughly $12 billion; a related defendant was extradited from Cyprus by way of Turkiye.
Referred is not recovered
Referred dollars are not recovered dollars. says it actually returned $811,787 to the retirement and FEHBP trust funds this quarter, some of it from older cases, and booked just $81,452 in new restitution and settlements. The $1.86 million is what the office pushed toward courts and administrators; what comes back trails it by quarters or years. And it is small against the documented losses in any one case -- the transnational scheme alone cost FEHBP about 15 times the quarter's entire referral figure.
The takeaway
- 's inspector general referred $1,856,784 for judicial or administrative action in the quarter ending June 2026 -- the output of health care fraud investigations spanning FEHBP psychotherapy, lab-testing, durable-equipment, and hearing-aid billing.
- One provider billed FEHBP for up to 50 hours of psychotherapy in a 24-hour day -- more than two full days of therapy charged in one calendar day -- and was paid $2.17 million from 2016 to 2022 before five people were indicted.
- A single transnational equipment scheme cost FEHBP carriers $28.24 million, roughly 15 times the quarter's whole referred-for-action figure and about 0.24% of the scheme's ~$12 billion total cost to all victims -- referred dollars capture only a sliver of documented program losses. (Scale comparison across different time bases, not a loss rate.)
Figures are from OPM OIG's Investigative Summary Report for the third quarter of fiscal 2026, covering April-June 2026 and fetched directly from oversight.gov, the federal Inspector General community's official publication portal. The report presumes innocent any referenced defendant not yet convicted; consistent with that, this piece names no individual and describes each case by provider type and court district only. The 15x and 0.24% comparisons and the "more than two full days" figure are this outlet's own arithmetic on figures the report states separately (methods and caveats in analysis.json).
A blind adversarial verifier, working only from the primary document with no access to this draft, independently checked every itemized fact and recomputed each derived figure; see verification.json.
Sources(2) ▾
- U.S. Office of Personnel Management, Office of the Inspector General (OPM OIG), OPM OIG Investigative Summary Report, Third Quarter of Fiscal Year 2026 (April-June 2026) (2026-07) — 's own quantitative accounting of its investigative work for the quarter ending June 2026: the dollars referred for judicial or administrative action, restitution and recoveries, dollars returned to the trust funds, FEHBP carrier fraud notifications, and hotline volume, plus case-by-case summaries of the health care and retirement fraud investigations. Source for every dollar figure and case detail in this piece. The report expressly presumes innocent any referenced defendant not yet convicted; this piece names no individual. oversight.gov
- U.S. Office of Personnel Management, OPM Office of the Inspector General (2026-08-14) — The issuing office's own page, cited to establish the 's identity and its public fraud-reporting hotline. No figure in this piece rests on it. opm.gov
Comments
Always open. Logged-in readers can annotate paragraphs in place.
's Office of Inspector General referred $1,856,784 for judicial or administrative action in the quarter ending June 2026 -- money its investigators tied to fraud, waste, abuse, or improper payments in federal employee benefit programs. The cases behind that number are lurid. One provider billed FEHBP for up to 50 hours of psychotherapy inside a single 24-hour day -- calls them "impossible days" -- and collected $2.17 million from 2016 to 2022 before five people were indicted.