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Program Assessment


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Inspector General Oversight of Federal Health Benefits Program

At the Office of Personnel Management, the Office of Inspector General detects fraud, waste, and abuse by health care providers and persons receiving benefits through Federal Employees Health Benefits and to ensure that health care benefit carriers comply with their contracts.


What This Rating Means


This is the highest rating a program can achieve. Programs rated Effective set ambitious goals, achieve results, are well-managed and improve efficiency.
  • The Office is the only entity that exercises ongoing, systematic oversight of Federal Employees Health Benefits Program. No significant design flaws exist that hamper the effectiveness of this Office oversight activities. A recent report on performance of all IGs indicated that this Office stood 6th out of 28 IGs in amount of audit recoveries and 5th in amount of recoveries from investigations.
  • The Office collaborates and coordinates effectively with related programs -- for instance, it both receives and gives full cooperation with the IG of Departments of Health and Human Services, Defense, and Veterans Affairs, FBI, and US Attorneys Office. OPM's OIG also actively interacts with professional groups such as the National Health Care Antifraud Association.
  • The Office closely monitors its oversight activities and collects performance data in real time. Key performance measures include: return on investment (dollars returned per direct oversight program dollar spent) and positive financial impact (actual recoveries plus management commitment to collect questioned costs). In FY 2005, the former was $8 and the latter was $122 million.

Improvement Plan

About Improvement Plans

We are taking the following actions to improve the performance of the program:

  • Improved budget requests to show what results to expect with the requested funds and provided evidence to demonstrate how it holds program managers and partners accountable for results.
  • Established ambitious targets for long-term and annual measures and demonstrated adequate progress in achieving these performance targets.
  • Conducted an independent evaluation of sufficient scope and quality and used the information to improve performance or demonstrated that it is helping agencies recruit and retain quality employees.

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The content on is developed by the U.S. Office of Management and Budget and Federal agencies.