John Hapchuk, CFE, CGFM
John Hapchuk has over 40 years of government auditing experience. He served as the DHHS Assistant Inspector General for Audit Management and Policy. DHHS is the parent agency to the Center for Medicare/Medicaid Services. In that capacity, he performed and oversaw a variety of highly complex advisory and program management services. Since his retirement, he has been a Senior Consultant with Strategic Management, working on a variety of consulting assignments.
He is a recognized expert in assuring that financial and performance audits and reviews are properly planned, efficiently executed, and that the results are evidenced-based and presented in a clear and concise manner. His efforts have greatly contributed to reducing errors and helped to assure that funds are only expended on beneficial program-related activities.
Previous Work Experience
During his government career, he held a series of increasingly more responsible assignments within the OIG. Rising first to being a Senior Auditor and later Audit Manager the Office of Inspector General’s (OIG) overseeing the Medicare Program. He also served as the national Medicaid Audit Manager. He later became the Office of Audit Services (OAS) Director of Program and Operations for health provider audits of questioned claims, unallowable costs, and other financial issues. Later as Director of Quality Assurance in the OAS, he was responsible for assuring that all work products (draft reports, final reports, briefing materials and Congressional testimony) met applicable professional standards. He was actively involved in assuring that the planning of audits, survey activities, data collection/analysis and reporting of results met applicable generally accepted government auditing standards.
Over his career he led numerous nationwide audits on the reasonableness of various types of payments made to Medicare providers. He developed a method to measure the relationship between Medicare inpatient prospective payments and the costs incurred by hospitals in treating those patients. Under his direction, a nationwide audit was conducted assessing hospitals’ abilities to justify claims for Medicare bad debts (uncollectable coinsurance and deductibles). Under his guidance, numerous Medicare secondary payer audits were conducted at various hospitals and at the headquarters of the Center for Medicare and Medicaid Services (CMS). His research activities provided useful insights on the relationship of indirect medical education and disproportionate share payments on hospital Medicare margins. He performed an audit of wage index calculations at CMS headquarters and developed a protocol for reviewing hospital-specific data used to generate the Medicare wage index. He was proactive in assessing CMS’ compliance in developing reasonable estimates of erroneous Medicare payments in accordance with the Improper Payments Improvement Act.
He was the OIG national coordinator for a national government initiative referred to as Operation Restore Trust that was project that developed innovative ways to fight Medicare waste, fraud and abuse in home health care, nursing care and medical supplies and services. In discharging the duties of that position, he spearheaded efforts to use multi-agency interdisciplinary teams to comprehensively review those health issues and apply them to other issues. The use of interdisciplinary teams became the foundation in subsequent OIG program integrity activities.
He also served in the OIG’s Office of Evaluation and Inspection (OEI) and as Director of the OIG Office of Management and Policy (OMP) that included being responsible for the oversight of almost $130 million per year expended by state Medicaid Fraud Control Units.