What's New
See also: Archive
July 2025
- 07-11-2025
- Medicare Home Health Agency Provider Compliance Audit: Sunflower Home Health A-05-23-00002
- A Large Northeastern Hospital Could Improve Certain Security Controls for Preventing and Detecting Cyberattacks A-18-22-08019
- Updated: Corporate Integrity Agreements
- 07-10-2025
- LEIE Database Updated with June 2025 Exclusions and Reinstatements
- 07-07-2025
- Advisory Opinion 25-08 Unfavorable opinion regarding a medical device company’s proposal to pay a third-party vendor to access an electronic billing system operated by the vendor that is used by some of the requestor’s customers for certain billing operations.
- 07-03-2025
- Medicare Home Health Agency Provider Compliance Audit: HRS Home Health A-05-22-00017
- 07-02-2025
- Advisory Opinion 25-06 Favorable opinion regarding assistance, including travel, lodging, and associated expenses, provided by a pharmaceutical manufacturer to qualifying patients receiving its gene therapy product and their caregivers.
- Advisory Opinion 25-07 Favorable opinion regarding a program operated by a pharmaceutical manufacturer to sponsor a companion laboratory test for eligible patients before a provider can prescribe a certain prescription drug manufactured by the pharmaceutical manufacturer.
- 07-01-2025
- CMS Should Improve Its Methodology for Collecting Medicare Postoperative Visit Data on Global Surgeries A-05-20-00021
June 2025
- 06-30-2025
- 2025 National Health Care Fraud Takedown: $14.6 BILLION in Alleged Fraud
- Acting Inspector General Juliet T. Hodgkins Remarks on the 2025 National Health Care Fraud Takedown
- Michigan Did Not Effectively Monitor Home Heating Benefits Provided Under the Low-Income Home Energy Assistance Program A-01-22-02502
- Advisory Opinion 25-05 Favorable opinion regarding a proposed arrangement pursuant to which a medical device manufacturer would offer up to $2,500 to reimburse purchasers for actual costs incurred associated with a needle stick injury caused by the failure of a device that it manufactures.
- 06-26-2025
- Availability of Surveyed Behavioral Health Providers to Treat New Patients Enrolled in Medicare and Medicaid OEI-09-21-00410
- 06-25-2025
- Video: Medicaid Fraud Control Units Annual Report: Fiscal Year 2024
- 06-23-2025
- Department of Health and Human Services’ Hybrid Work Environment as of May 2024 A-05-24-00008
- 06-20-2025
- Advisory Opinion 25-04 Unfavorable opinion regarding a medical device company’s proposal to pay the costs its customers otherwise would incur for a third-party company to screen and monitor the requestor for exclusion from Federal health care programs and to ensure compliance with certain other legal requirements.
- Part D Plans Generally Include Drugs Commonly Used by Dual-Eligible Enrollees: 2025 OEI-05-25-00120
- 06-17-2025
- Video: HHS-OIG's Spring 2025 Semiannual Report to Congress
- 2024 Performance Data for the Senior Medicare Patrol Projects OEI-02-25-00160
- 2025 Fall OIG Health Care Fraud and Abuse Legal Internship Announcement
- Updated: Corporate Integrity Agreements
- 06-16-2025
- Maine Could Better Ensure That Intermediate Care Facilities for Individuals With Intellectual Disabilities Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-01-24-00004
- Updated: Work Plan
- 06-13-2025
- Eleven of Thirty Selected Hospitals Did Not Comply With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments A-02-22-01003
- 06-12-2025
- Ten of Thirty Selected Nursing Facilities Did Not Comply or May Not Have Complied With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments A-05-22-00012
- 06-11-2025
- Advisory Opinion 25-03 Favorable opinion regarding a proposed arrangement whereby a management support organization and an affiliated professional corporation would enter into an agreement with telehealth providers to lease employees and provide certain administrative services.
- NIH Recipients Conducting Biospecimen Research: Gaps in Emergency Planning and Reporting OEI-04-23-00280
- 06-10-2025
- LEIE Database Updated with May 2025 Exclusions and Reinstatements
- 06-09-2025
- CMS Use of Staffing Data To Inform State Oversight of Nursing Homes OEI-04-22-00550
- Updated: Corporate Integrity Agreements
- Updated: CMP and Affirmative Exclusions
- Updated: EMTALA Patient Dumping
- Updated: Fraud Self-Disclosures
- Updated: CIA Reportable Events
- 06-06-2025
- HHS’s Grant Payment System Lacked Effective Internal Controls To Prevent $7.8 Million in Fraud, and HHS Has Begun Taking Corrective Actions To Reduce Fraud Risk A-18-24-03700
- 06-05-2025
- FDA Food Safety Inspections of Domestic Food Facilities OEI-02-23-00300
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health and Life Insurance Company (Contract H1608) Submitted to CMS A-02-22-01020
- 06-03-2025
- Indian Health Service's Controls Over Sanitation Facilities Construction Program Projects Funded Under the Infrastructure Investment and Jobs Act Could Be Improved A-05-22-00021
- 06-02-2025
- Spring Semiannual Report to Congress
- At a Glance: Spring Semiannual Report to Congress
- California Medicaid Fraud Control Unit: 2023 Inspection OEI-06-23-00450
May 2025
- 05-30-2025
- Minnesota Could Better Ensure That Childcare Assistance Providers Comply With Attendance Requirements A-05-24-00001
- 05-28-2025
- Medicare Payments for Evaluation and Management Services Provided on the Same Day as Eye Injections Were at Risk for Noncompliance With Medicare Requirements A-09-23-03014
- 05-22-2025
- Potential Cost Savings in HHS Programs: HHS Actions
- Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for Fiscal Year 2024 OAS-25-17-042
- 05-21-2025
- Updated: Corporate Integrity Agreements
- 05-19-2025
- Maryland Did Not Comply With Federal Waiver and State Requirements at 20 Adult Day Care Facilities Audited A-03-24-00201
- 05-16-2025
- CMS Is Not Systematically Tracking Whether States Return Federal Shares of Medicaid Managed Care Remittances OEI-03-23-00041
- 05-15-2025
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2024 OEI-03-25-00030
- Updated: Work Plan
- 05-09-2025
- LEIE Database Updated with April 2025 Exclusions and Reinstatements
- Updated: Corporate Integrity Agreements
- Updated: CMP and Affirmative Exclusions/EMTALA Patient Dumping
- Updated: Fraud Self-Disclosures
- 05-07-2025
- Most Medicare Part D Plans’ Formularies Included Humira Biosimilars for 2025 OEI-05-23-00520
- 05-06-2025
- Potential Cost Savings in HHS Programs: Legislative Actions
April 2025
- 04-25-2025
- Updated: Corporate Integrity Agreements
- Risk Assessment of the Administration for Community Living’s Travel Card Program for Fiscal Year 2022 A-04-24-02043
- 04-24-2025
- Updated: CMP and Affirmative Exclusions
- Updated: Stipulated Penalties and Material Breaches
- 04-15-2025
- Ohio Did Not Comply With Federal Waiver and State Requirements at 18 of 19 Adult Day Care Facilities Audited A-05-23-00006
- Updated: Work Plan
- 04-14-2025
- Fewer than One in Five Medicare Enrollees Received Medication to Treat Their Opioid Use Disorder OEI-02-24-00430
- 04-11-2025
- Updated: Fraud Risk and Heightened Scrutiny 2025 Q1-Q2
- 04-10-2025
- LEIE Database Updated with March 2025 Exclusions and Reinstatements
- Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings OAS-25-04-007
- ASPR Established Adequate Controls for Maintaining Physical Security and Inventory Records at Stockpile Site D OAS-25-04-001
- Risk Assessment of the Administration for Community Living’s Purchase Card Program for Fiscal Year 2022 A-04-24-02042
- 04-09-2025
- Advisory Opinion 25-02 Favorable opinion regarding an arrangement whereby Requestor— designated as a community health center pursuant to Section 330 of the Public Health Service Act—proposes, during the provision of certain social services to individuals, to: (1) identify individuals in need of primary care services; (2) inform them of the availability of such services; and (3) schedule an appointment for them to receive primary care services from Requestor or refer them to a local primary care provider.
- 04-08-2025
- Updated: Fraud Self-Disclosures
- Updated: CIA Reportable Events
- 04-07-2025
- Updated: Corporate Integrity Agreements
- 04-03-2025
- Most Institutions That Received NIH Funding Did Not Fully Understand When They Must Report Monetary Donations OEI-03-22-00570
March 2025
- 03-31-2025
- Updated: Corporate Integrity Agreements
- 03-26-2025
- Updated: Corporate Integrity Agreements
- 03-21-2025
- SAMHSA’s FindTreatment.gov Contained Some Inaccurate Information on Substance Use and Mental Health Treatment Facilities A-09-23-01003
- 03-19-2025
- Medicare Administrative Contractors Did Not Consistently Meet Medicare Cost Report Oversight Requirements A-04-22-06264
- 03-17-2025
- Updated: Work Plan
- 03-14-2025
- State Survey Agencies Need Additional Guidance to Assess Nursing Home Emergency Preparedness Programs OEI-04-23-00030
- 03-13-2025
- Little Overlap Exists Between ORR-Funded Foster Care and the US Domestic Foster Care System OEI-07-24-00320
- Updated: Fraud Self-Disclosures
- Updated: CIA Reportable Events
- 03-12-2025
- Medicaid Fraud Control Units Annual Report: Fiscal Year 2024 OEI-09-25-00090
- 03-11-2025
- Texas Did Not Fully Comply With Federal Waiver and State Health, Safety, and Administrative Requirements at All 20 Adult Day Activity Health and Service Facilities Audited A-06-23-05000
- 03-10-2025
- LEIE Database Updated with February 2025 Exclusions and Reinstatements
- 03-06-2025
- Medicare and Medicaid Payments to Providers Are at Risk of Diversion Through Electronic Funds Transfer Fraud Schemes OEI-07-23-00180
- Updated: CMP and Affirmative Exclusions/EMTALA
- Updated: Fraud Self-Disclosures
- 03-05-2025
- Updated: Corporate Integrity Agreements
- Updated: Fraud Risk and Heightened Scrutiny 2025 Q1
- 03-04-2025
- North Carolina’s Medicaid Control Environment, Risk Management Practices, and Governing Processes Were Assessed as Moderate Risk A-04-21-00127
- Updated: Heightened Scrutiny
- 03-03-2025
- Florida Generally Used CDC Public Health Crisis Response Cooperative Agreement Program Funds in Accordance With Federal Requirements A-02-23-02008
February 2025
- 02-28-2025
- ACF Used Contractor Personnel To Perform Inherently Governmental Functions and Paid Millions in Potentially Unallowable Costs A-12-22-10000
- CDC Lacked Documentation for Its Redirections of PEPFAR Funds to Support the COVID-19 Response A-04-23-01028
- 02-27-2025
- Office of Inspector General’s Partnership With the Commonwealth of Massachusetts, Office of the State Auditor: Office of Medicaid (MassHealth) – Review of Capitation Payments With Multiple Identification Numbers A-01-23-00004
- 02-26-2025
- Medicare Contractors Did Not Use Complete and Timely Utilization Data When Making Part B Coverage Determinations for Stelara OEI-BL-19-00501
- 02-24-2025
- Medicare Part D Spending for 10 Selected Diabetes Drugs Totaled $35.8 Billion in 2023, an Increase of 364 Percent From 2019 A-05-24-00015
- Office of Inspector General’s Partnership With the Office of the Washington State Auditor: State Auditor’s Report Examining Washington’s Concurrent Medicaid Enrollments A-09-23-02009
- 02-21-2025
- Massachusetts Generally Claimed Safety Net Care Pool Costs That Complied With Federal Requirements A-04-22-04091
- 02-20-2025
- Medicare Paid Claims That Were Not in Accordance With the Over-the- Counter COVID-19 Test Kits Demonstration Quantity Limitation A-06-23-06000
- Mental Health Center of Florida Generally Met Medicare Billing Requirements for Some Psychotherapy Services A-04-21-06251
- 02-19-2025
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2024 OEI-03-25-00020
- 02-18-2025
- Not All Medicare Enrollees Are Continuing Treatment for Opioid Use Disorder OEI-02-23-00360
- Colorado Made Capitation Payments to Managed Care Organizations After Enrollees’ Deaths A-07-21-05132
- Updated: Work Plan
- 02-12-2025
- Modification of Advisory Opinion 21-13 Modification of favorable opinion regarding the subsidization of enrollee cost-sharing obligations for Medicare-covered services provided as part of a clinical trial.
- 02-10-2025
- LEIE Database Updated with January 2025 Exclusions and Reinstatements
- 02-07-2025
- Updated: Corporate Integrity Agreements
- 02-06-2025
- Medicare Improperly Paid Suppliers for Intermittent Urinary Catheters A-09-22-03019
- West Virginia Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-23-06109
- 02-04-2025
- Wisconsin Medicaid Fraud Control Unit: 2024 Inspection OEI-07-24-00220
January 2025
- 01-21-2025
- Video: OIG Office of Audit Services | Impacting Health & Human Services Programs and the Lives of Americans
- 01-17-2025
- Independent Attestation Review: Centers for Medicare & Medicaid Services Fiscal Year 2024 Detailed Accounting Submission and Fiscal Year 2026 Budget Formulation Compliance Report for National Drug Control Activities, and the Accompanying Required Assertion OAS-25-03-018
- Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2024 Detailed Accounting Submission and Fiscal Year 2026 Budget Formulation Compliance Report for National Drug Control Activities, and the Accompanying Required Assertion OAS-25-03-016
- ASPR Established Adequate Controls for Maintaining Physical Security and Inventory Records at Stockpile Site C A-04-24-02047
- 01-16-2025
- Updated: CMP and Affirmative Exclusions
- Updated: Fraud Self-Disclosures
- 01-15-2025
- Advisory Opinion 25-01 Favorable opinion regarding a program to provide free access to a pharmaceutical product to patients who meet financial and other eligibility criteria and who do not have adequate coverage for the product.
- Updated: Work Plan
- 01-14-2025
- How FDA Used Its Accelerated Approval Pathway Raised Concerns in 3 of 24 Drugs Reviewed OEI-01-21-00400
- 01-13-2025
- Updated: Corporate Integrity Agreements
- 01-10-2025
- LEIE Database Updated with December 2024 Exclusions and Reinstatements
- Job Opening: FOIA General Attorney (Senior Counsel)
- 01-08-2025
- Updated: Corporate Integrity Agreements
- 01-03-2025
- Medicare Could Save Billions With Comparable Access for Enrollees if Critical Access Hospital Payments for Swing-Bed Services Were Similar to Those of the Fee-for-Service Prospective Payment System A-05-21-00018
- 01-02-2025
- Florida Did Not Comply With Federal Waiver and State Requirements at 18 of 20 Adult Day Care Facilities Reviewed A-04-23-000135
Archive
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December 2024
- 12-31-2024
- Advisory Opinion 24-13 Favorable opinion regarding assistance for certain travel, lodging, meals, and associated expenses for qualifying patients receiving a cell therapy product manufactured by a pharmaceutical manufacturer.
- 12-26-2024
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UCare Minnesota (Contract H2459) Submitted to CMS A-07-22-01209
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes Blue Care Network of Michigan (Contract H5883) Submitted to CMS A-06-20-02000
- ICAP at Columbia University Generally Managed Its PEPFAR Expenditures Appropriately but Lacked a Robust Financial Management System A-04-20-01020
- 12-23-2024
- Total Medicare Part B Spending on Lab Tests Decreased in 2023, Driven in Part by Less Spending on COVID-19 Tests OEI-09-24-00350
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Triple-S Advantage, Inc., (Contract H5774) Submitted to CMS A-04-21-07095
- Medicare Home Health Agency Provider Compliance Audit: Bridge Home Health A-05-23-00017
- 12-20-2024
- Some HHS Requirements for Vetting Mobile Apps Were Not Followed Prior to the Release of the AHRQ Question Builder App A-18-22-09008
- Providers Used Medicare Part D Eligibility Verification Transactions for Permissible Purposes A-05-22-00022
- Some Selected Skilled Nursing Facilities Did Not Comply With Medicare Requirements for Reporting Related-Party Costs A-07-21-02836
- Updated: Corporate Integrity Agreements
- Updated: CMP and Affirmative Exclusions/EMTALA
- 12-19-2024
- Medicaid Gross Spending on 10 Selected Diabetes and 2 Selected Weight Loss Drugs Totaled More Than $9 Billion in 2023, an Increase of 540 Percent From 2019 A-05-24-00016
- Indiana Made at Least $56 Million in Improper Fee-for-Service Medicaid Payments for Applied Behavior Analysis Provided to Children Diagnosed With Autism A-09-22-02002
- Twelve Selected States Did Not Accurately Calculate the Federal Share of Medicaid Collections Subject to the Increased COVID-19 Federal Medical Assistance Percentages A-06-23-09002
- Updated: Corporate Integrity Agreements
- 12-18-2024
- Summary Report of Prior Office of Inspector General Cyber Threat Hunt Audits of Eight HHS Operating Division Networks A-18-22-07002
- 12-17-2024
- Advisory Opinion 24-11 Favorable opinion regarding the provision of meningococcal vaccinations to eligible patients prescribed one of two drugs that carry a heightened risk of contracting meningococcal disease.
- Advisory Opinion 24-12 Favorable opinion regarding a program to sponsor genetic testing, related genetic counseling, and disease-state awareness education regarding certain hereditary conditions that may cause kidney stones.
- Updated: Work Plan
- 12-16-2024
- Update: Xolair Prefilled Syringes Likely Meet Part B Coverage Criteria OEI-BL-24-00440
- Updated: Corporate Integrity Agreements
- 12-13-2024
- Updated: Corporate Integrity Agreements
- 12-12-2024
- Advisory Opinion 24-10 Favorable opinion regarding a dental supplies distributor’s proposed expansion of its existing customer loyalty program for purchases of dental-related items and services.
- Updated: CMP and Affirmative Exclusions
- 12-10-2024
- Featured Topic: PHHS Grants and Contracts
- LEIE Database Updated with November 2024 Exclusions and Reinstatements
- 12-06-2024
- FY 2023 Health Care Fraud and Abuse Control Program Report
- Updated: Corporate Integrity Agreements
- Updated: CMP and Affirmative Exclusions/EMTALA
- Updated: Fraud Self-Disclosures
- 12-05-2024
- Findings of Whistleblower Retaliation by Administration for Strategic Preparedness and Response Management Official
- 12-04-2024
- Fall 2024 Semiannual Report to Congress
- HHS-OIG's Efforts Result in $7.13 Billion in Expected Recoveries and Receivables, According to Fall 2024 Semiannual Report
- CGS Administrators, LLC, Did Not Reopen and Recalculate Most Selected Hospices’ Caps for Years Prior to 2020 A-06-23-09003
- 12-03-2024
- Updated: Corporate Integrity Agreements
- The Organ Procurement and Transplantation Network IT System’s Cybersecurity Controls Were Partially Effective and Improvements Are Needed A-18-22-03400
- Nonprofit and Government-Owned Nursing Homes Generally Complied With Federal Requirements Regarding the Infection Preventionist Position A-01-24-00002
November 2024
- 11-29-2024
- Texas Generally Claimed Medicaid Reimbursement for Fee-for-Service Inpatient Hospital Claims With Malnutrition Diagnosis Codes in Accordance with Federal and State Requirements A-06-22-04002
- Selected Home Health Agencies Complied With Terms and Conditions and Federal Requirements for Provider Relief Fund Payments A-01-22-00503
- 11-27-2024
- Puerto Rico Did Not Designate a Medicaid Contracts Oversight Lead in a Timely Manner and Certified Contracts That Were Noncompliant A-02-24-01002
- 11-26-2024
- CDC's and SAMHSA's Processes for and Challenges With Compiling Data for the National Drug Control Assessment A-03-24-00353
- 11-25-2024
- The Office for Civil Rights Should Enhance Its HIPAA Audit Program to Enforce HIPAA Requirements and Improve the Protection of Electronic Protected Health Information A-18-21-08014
- Advisory Opinion 24-09 Favorable opinion regarding: a proposal for a municipal corporation to begin billing patients' insurance plans—and waiving any patient cost-sharing amounts—for treatment-in-place emergency medical services without an associated ambulance transport.
- 11-20-2024
- Nursing Facility Industry Segment-Specific Compliance Program Guidance
- 11-19-2024
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2024 A-18-24-11200
- 11-18-2024
- 2024 Top Management & Performance Challenges Facing HHS
- Medicare Improperly Paid Acute-Care Hospitals an Estimated $190 Million Over 5 Years for Outpatient Services Provided to Hospice Enrollees A-09-23-03024
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2024 OEI-03-25-00010
- Job Opening: FOIA General Attorney (Associate Counsel)
- 11-15-2024
- Updated: Work Plan
- Updated: Corporate Integrity Agreements
- Washington State's Oversight Could Better Ensure That Adult Family Homes Comply With Health and Safety and Administrative Requirements A-09-23-02002
- Utah Generally Operated Its Medicaid Estate Recovery Program in Accordance With Requirements and in a Cost Effective Manner, but Utah Did Not Have Formal Written Procedures A-07-23-03257
- 11-14-2024
- Maine Did Not Comply With Screening, Assessment, and Investigation Requirements for Responding to Reports of Child Abuse and Neglect A-01-23-02500
- Seven of Thirty Hospices Reviewed Did Not Comply or May Not Have Complied With Terms and Conditions and Federal Requirements for Provider Relief Fund Payments A-02-22-01014
- National Government Services, Inc., Reopened and Corrected Cost Report Final Settlements With Obvious Errors To Collect Overpayments Made to Medicare Providers A-06-24-05000
- Updated: Heightened Scrutiny
- 11-13-2024
- Findings of Retaliation by Management Official in the HHS Office of the Chief Information Officer
- 11-08-2024
- LEIE Database Updated with October 2024 Exclusions and Reinstatements
- Not All Selected Hospitals Complied With the Hospital Price Transparency Rule A-07-22-06108
- Updated: CMP and Affirmative Exclusions
- Updated: Fraud Self-Disclosures
- 11-07-2024
- National Background Check Program for Long-Term Care Providers: A Final Assessment OEI-07-24-00100
- Updated: Corporate Integrity Agreements
- 11-01-2024
- Updated: CMP and Affirmative Exclusions, EMTALA/Patient Dumping
October 2024
- 10-31-2024
- Job Opening: Administrative and Civil Remedies Branch (ACRB) and Industry Guidance Branch (IGB) Attorney
- Updated: Corporate Integrity Agreements
- 10-29-2024
- ASPR Established Adequate Controls for Maintaining Physical Security and Inventory Records at Stockpile Site B A-04-24-02046
- 10-25-2024
- California Used CARES Act Funds for Unallowable Nutrition Services Program Expenditures A-06-22-01004
- Massachusetts Could Better Ensure That Intermediate Care Facilities for Individuals With Intellectual Disabilities Comply With Federal Requirements for Life Safety and Emergency Preparedness A-01-24-00001
- 10-24-2024
- Medicare Advantage: Plans Still Using Questionable Health Risk Assessments to Boost Medicare Payments by Billions OEI-03-23-00380
- 10-22-2024
- Medicare Part D Paid Millions for Drugs for Which Payment Was Available Under the Medicare Part A Skilled Nursing Facility Benefit A-09-21-03008
- Updated: CMP and Affirmative Exclusions
- 10-17-2024
- 2024 Top Unimplemented Recommendations
- 10-16-2024
- Employee Profile: Kofi Ansah-Brew
- 10-15-2024
- Updated: Work Plan
- 10-11-2024
- Updated: Fraud Risk and Heightened Scrutiny Q1-Q4
- Updated: Annual Inflation Updates to the Annual Cap on Patient Engagement Tools and Supports Under 42 CFR § 1001.952(hh)
- 10-10-2024
- HHS-OIG: Strengthening Cybersecurity in Health Care
- LEIE Database Updated with September 2024 Exclusions and Reinstatements
- Finding of Retaliation by Administration Children and Families Grantee
- 10-09-2024
- Massachusetts Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-01-23-00003
- 10-08-2024
- Updated: Fraud Self-Disclosures
- 10-04-2024
- HHS Continues to Make Progress Toward Compliance With the Geospatial Data Act A-18-24-03500
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2023 A-18-24-11300
- 10-03-2024
- New Strategic Plan: Safeguarding the Integrity of HHS Grants and Contracts
- 10-02-2024
- States Could Better Leverage Coverage and Access Requirements To Promote Maternal Health Care Access in Medicaid Managed Care OEI-05-22-00330
September 2024
- 09-30-2024
- ASPR Established Adequate Controls for Maintaining Physical Security Over Stockpile Site A, but Some Inventory Discrepancies Were Identified A-04-24-02044
- 09-27-2024
- Featured Article: HHS-OIG's Efforts to Address the Opioid Epidemic
- 09-26-2024
- Gallup Indian Medical Center—an IHS-Operated Health Facility—Did Not Timely Conduct Required Background Checks of Staff and Supervise Certain Staff A-02-23-02006
- Medicare Advantage Compliance Audit of Diagnosis Codes That EmblemHealth (Contract H3330) Submitted to CMS A-06-18-02001
- 09-25-2024
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Humana Health Plan, Inc. (Contract H2649) Submitted to CMS A-02-22-01001
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HealthAssurance, Pennsylvania, Inc. (Contract H5522) Submitted to CMS A-05-22-00020
- 09-24-2024
- Additional Oversight of Remote Patient Monitoring in Medicare Is Needed OEI-02-23-00260
- Systemic and Operational Challenges Hinder Efforts to Ensure HIV Care for Medicaid Enrollees OEI-05-22-00242
- 09-23-2024
- Medicare and Medicaid Enrollees in Many High-Need Areas May Lack Access to Medications for Opioid Use Disorder OEI-BL-23-00160
- 09-19-2024
- CMS Recovered Medicare Payments to Providers Under the COVID-19 Accelerated and Advance Payments Program in Compliance With Federal Requirements A-05-23-00005
- 09-18-2024
- Revised Medicaid Fraud Control Unit Performance Standards
- 09-17-2024
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2022 Average Sales Prices OEI-03-24-00080
- 09-16-2024
- Updated: Work Plan
- 09-13-2024
- Novitas Solutions, Inc., Reopened and Corrected Cost Report Final Settlements With Obvious Errors To Collect Overpayments Made to Medicare Providers A-06-23-05001
- Advisory Opinion 24-08 Unfavorable advisory opinion regarding an entity's proposal to share a percentage of its savings with certain groups to which it provides coverage through Employer Group Waiver Plans.
- 09-12-2024
- Updated: Corporate Integrity Agreements
- 09-11-2024
- Featured Topic: The Emergency Medical Treatment and Labor Act (EMTALA)
- Updated: Fraud Self-Disclosures
- Spring 2025 OIG Health Care Fraud and Abuse Legal Internship
- 09-10-2024
- Most Children in Foster Care Did Not Receive Credit Checks and Assistance OEI-07-22-00510
- LEIE Database Updated with August 2024 Exclusions and Reinstatements
- 09-09-2024
- Employee Profile: Amanda Sutter
- 09-05-2024
- New Mexico Did Not Ensure Attendants Were Qualified To Provide Personal Care Services, Putting Medicaid Enrollees at Risk A-06-22-02000
- 09-03-2024
- Massachusetts Opioid Treatment Program Services Met Many of the Federal and State Requirements A-01-23-00002
- 08-29-2024
- South Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-22-07010
- Utah Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements A-07-24-07013
- 08-23-2024
- Advisory Opinion 24-07 Favorable opinion regarding a proposed patient assistance program operated by a nonprofit grant-making organization.
- 08-21-2024
- Kansas's Implemented Electronic Visit Verification System Could Be Improved A-07-23-03255
- 08-20-2024
- Certain For-Profit Nursing Homes May Not Have Complied With Federal Requirements Regarding the Infection Preventionist Position A-01-22-00001
- 08-19-2024
- Illinois MMIS and E&E System Had Adequate Security Controls in Place, but Some Improvements Are Needed A-18-22-09009
- 08-16-2024
- Updated: Corporate Integrity Agreements
- Updated: CMP and Affirmative Exclusions
- 08-15-2024
- Updated: Work Plan
- Massachusetts Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements A-02-24-01001
- 08-14-2024
- Medicare Advantage Compliance Audit of Diagnosis Codes That MMM Healthcare, LLC, (Contract H4003) Submitted to CMS A-04-20-07090
- 08-13-2024
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2024 OEI-03-24-00070
- Office of Inspector General's Partnership With the Ohio Auditor of State: Auditor of State's Report Ohio Department of Medicaid: The Cost of Concurrent Enrollment A-09-23-02004
- 08-12-2024
- Medicare Improperly Paid Hospitals an Estimated $79 Million for Enrollees Who Had Received Mechanical Ventilation A-09-22-03002
- Updated: Fraud Self-Disclosures
- 08-09-2024
- Medicare and Some Enrollees Paid Substantially More When Stelara Was Covered Under Part D Versus Part B OEI-BL-19-00500
- LEIE Database Updated with July 2024 Exclusions and Reinstatements
- 08-07-2024
- Opioid Treatment Programs in Washington State Did Not Fully Comply With Federal and State Requirements, Which May Have Put Medicaid Enrollees at Risk for Poor Treatment Outcomes A-09-21-02001
- Updated: Corporate Integrity Agreements
- 08-05-2024
- CDC Provided Oversight and Assistance, but Recipients Faced Challenges in Implementing a COVID-19 Vaccine Confidence Strategy A-06-22-04004
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2023 in Accordance With Federal Requirements A-04-24-02045
- 08-02-2024
- Alaska Medicaid Fraud Control Unit: 2023 Inspection OEI-07-23-00240
- 07-31-2024
- Updated: Fraud Risk and Heightened Scrutiny Q1-Q3
- 07-29-2024
- Employee Profile: Melissa C. Tucker
- West Virginia Medicaid Fraud Control Unit: 2023 Inspection OEI-09-23-00390
- Heluna Health May Not Have Used California's CDC COVID-19 Funds in Accordance With Award Requirements A-04-22-02037
- 07-26-2024
- California Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State A-05-23-00008
- 07-23-2024
- Advisory Opinion 24-06 Unfavorable opinion regarding proposed assistance for fertility services for qualifying patients receiving a gene therapy treatment developed by a biotechnology company.
- 07-22-2024
- Advisory Opinion 24-05 Favorable in part and unfavorable in part opinion regarding proposed assistance for: (i) travel, lodging, meals, and associated expenses; and (ii) fertility preservation services for qualifying patients receiving one of two gene therapy treatments developed by a publicly traded biotechnology company.
- HHS Office of the Secretary Needs to Improve Key Security Controls to Better Protect Certain Cloud Information Systems A-18-22-08018
- Updated: Corporate Integrity Agreements
- 07-16-2024
- Job Opening: Schedule A Persons with Disability Opportunity: Criminal Investigator GL-1811-09 (Closes July 22)
- ASPR Did Not Consistently Comply With Federal Requirements for Awarding Research and Development Contracts A-03-20-03003
- Updated: Corporate Integrity Agreements
- 07-15-2024
- Updated: Work Plan
- 07-12-2024
- Updated: Corporate Integrity Agreements
- 07-11-2024
- Updated: Corporate Integrity Agreements
- 07-10-2024
- LEIE Database Updated with June 2024 Exclusions and Reinstatements
- 07-08-2024
- NEW HHS-OIG Impact Brief: Medicare Advantage Fraud
- Updated FAQ: General Questions Regarding Certain Fraud and Abuse Authorities
- 07-05-2024
- Updated: Fraud Self-Disclosures
- Updated: Grant and Contractor Fraud Self-Disclosures
- 07-02-2024
- 2023 Performance Data for the Senior Medicare Patrol Projects OEI-02-24-00260
- 07-01-2024
- Updated: CMP and Affirmative Exclusions
- 06-28-2024
- Part D Plans Generally Include Drugs Commonly Used by Dual-Eligible Enrollees: 2024 OEI-05-24-00210
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2023 A-18-23-11200
- 06-27-2024
- 2024 Nationwide Health Care Fraud Enforcement Action
- The National Institutes of Health Has Made Progress But Could Further Improve Its Closeout Process for Grants and Similar Awards A-04-23-08097
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Independent Health Association, Inc. (Contract H3362) Submitted to CMS A-07-19-01194
- 06-26-2024
- Many States Lack Information To Monitor Maltreatment in Residential Facilities for Children in Foster Care OEI-07-22-00530
- 06-25-2024
- North Carolina Did Not Report and Return All Medicaid Overpayments for the State's Medicaid Fraud Control Unit Cases A-06-23-04004
- 06-20-2024
- NIH Did Not Close Contracts in Accordance With Federal Requirements, Resulting in the Increased Risk of Fraud, Waste, and Abuse A-04-23-03585
- Advisory Opinion 24-04 Favorable opinion regarding: (i) a limited-time program to refund, waive, or delay requiring receipt of payment for a drug in the event of an insurance reimbursement denial or delay; and (ii) certain discounts to the cost of the drug.
- 06-18-2024
- Updated: Corporate Integrity Agreements
- 06-17-2024
- Updated: Work Plan
- Advisory Opinion 24-03 Favorable opinion regarding assistance, including travel, lodging, meals, and associated expenses, provided by a pharmaceutical manufacturer to qualifying patients receiving its gene therapy product and their caregivers.
- 06-13-2024
- The Food and Drug Administration's Inspection and Recall Process Should Be Improved To Ensure the Safety of the Infant Formula Supply A-01-22-01502
- CMS Could Strengthen Program Safeguards To Prevent and Detect Improper Medicare Payments for Short Inpatient Stays A-09-21-03022
- 06-11-2024
- Updated: Corporate Integrity Agreements
- 06-10-2024
- LEIE Database Updated with May 2024 Exclusions and Reinstatements
- Washington Medicaid Fraud Control Unit: 2023 Inspection OEI-09-23-00230
- 06-07-2024
- Updated: Fraud Self-Disclosures
- 06-04-2024
- Updated: Corporate Integrity Agreements
- 06-03-2024
- Spring 2024 Semiannual Report to Congress
- HHS-OIG Reports Nearly $3 Billion in Expected Recoveries in Newly Streamlined Semiannual Report
- OpEd: Pandemic lessons must spur federal action to protect nursing home residents
- 05-30-2024
- Fall 2024 OIG Health Care Fraud and Abuse Legal Internship
- 05-29-2024
- Medicare Remains Vulnerable to Fraud, Waste, and Abuse Related to Off-the-Shelf Orthotic Braces, Which May Result in Improper Payments and Impact the Health of Enrollees A-09-21-03019
- 05-28-2024
- Plans and Enrollment Often Fell Short for Underrepresented Groups in a Sample of NIH-Funded Clinical Trials OEI-01-21-00320
- 05-23-2024
- Medicaid Managed Care: States Do Not Consistently Define or Validate Paid Amount Data for Drug Claims OEI-03-20-00560
- 05-22-2024
- Wanted Fugitive: Dr. Yogeshwar Singh "Garry" Gill
- Selected CDC Racial and Ethnic Approaches to Community Health Program Recipients Generally Complied With Federal Requirements But Did Not Meet All Targets and Charged Some Unallowable Costs A-02-22-02001
- 05-21-2024
- California Improperly Claimed $52.7 Million in Federal Medicaid Reimbursement for Capitation Payments Made on Behalf of Noncitizens With Unsatisfactory Immigration Status A-09-22-02004
- 05-20-2024
- Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for the Fiscal Year 2023 A-17-24-52000
- Updated: Corporate Integrity Agreements
- Office of Counsel Job Opening: Special Policy Advisor/Reviewing Official
- 05-16-2024
- Employee Profile: Deputy Regional Inspector General Meridith Seife: Creative Problem Solving to Make Meaningful, Positive Change in People's Lives
- Updated: Corporate Integrity Agreements
- 05-15-2024
- Updated: Work Plan
- Colorado Did Not Report and Refund the Correct Federal Share of Medicaid-Related Overpayments for Some Cases Identified by the State's Program Integrity Section A-07-19-02816
- 05-14-2024
- New York Medical College Claimed Unallowable Grant Costs and Did Not Meet Certain Financial Conflict of Interest Requirements A-04-20-03583
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2023 OEI-03-24-00060
- 05-13-2024
- New Mexico Should Refund Almost $120 Million to the Federal Government for Medicaid Nursing Facility Level-of-Care Managed Care Capitated Payments A-06-20-09001
- Updated: CMP and Affirmative Exclusions
- 05-10-2024
- LEIE Database Updated with April 2024 Exclusions and Reinstatements
- Potential Vulnerabilities in CMS Oversight of Medicare Add-on Payments for COVID-19 Tests Show That Oversight of Incentive Payments Could Be Improved A-09-22-03015
- State Agencies Could Be Obtaining Hundreds of Millions in Additional Medicaid Rebates Associated With Physician-Administered Drugs A-07-23-06111
- 05-09-2024
- California Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements A-09-24-02001
- Updated: Corporate Integrity Agreements
- 05-08-2024
- Survey on the Role of Patient Selection Criteria in Ensuring Equitable Access to Kidney Transplantation
- Updated: Fraud Self-Disclosures
- Updated: Corporate Integrity Agreements
- 05-07-2024
- Office of Inspector General's Partnership With the State of Rhode Island, Office of the Auditor General: Medicaid Capitation Paid for Members Residing in Other States A-01-23-00001
- 05-02-2024
- Medicaid Enrollees May Not Be Screened for Intimate Partner Violence Because of Challenges Reported by Primary Care Clinicians OEI-03-21-00310
- 05-01-2024
- Updated: FY 2024 Q1-Q2 False Claims Act Settlements on the Risk Spectrum
- 04-30-2024
- The Office of Intergovernmental and External Affairs' Purchase Card Program Did Not Comply With Federal and HHS Requirements A-03-22-00500
- 04-29-2024
- Florida Ensured That Nursing Homes Complied with Federal Background Check Requirements A-04-23-08100
- 04-25-2024
- West Virginia Lacked Effective Oversight of Its Opioid Response Grants A-06-22-01005
- 04-22-2024
- SENTENCED: Lilit Galstyan, Former HHS-OIG Fugitive
- 04-18-2024
- 28th Annual Compliance Institute - HHS-OIG Enforcement and Compliance Update
- 04-16-2024
- The Testimony of Inspector General Christi A. Grimm: Examining How Improper Payments Cost Taxpayers Billions and Weaken Medicare and Medicaid
- 04-15-2024
- Updated: Work Plan
- Updated: Corporate Integrity Agreements
- 04-11-2024
- Ohio Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements A-05-23-00019
- Advisory Opinion 24-02 Favorable opinion regarding patient assistance funds operated by a nonprofit, tax exempt charitable organization.
- 04-10-2024
- LEIE Database Updated with March 2024 Exclusions and Reinstatements
- Updated: Corporate Integrity Agreements
- 04-05-2024
- CMS Could Improve Its Procedures for Setting Medicare Clinical Diagnostic Laboratory Test Rates Under the Clinical Laboratory Fee Schedule for Future Public Health Emergencies A-01-21-00506
- Missouri May Not Have Used All CARES Act Funds for the Older Americans Act Nutrition Services Program in Accordance With Federal and State Requirements A-07-22-04130
- Alabama MMIS and E&E System Security Controls Were Adequate, but Some Improvements Are Needed A-18-22-09010
- 04-04-2024
- New York Generally Identified and Corrected Duplicate Children's Health Insurance Plan Payments Made to Managed Care Organizations A-02-23-01017
- Alabama Claimed Federal Medicaid Reimbursement for Millions of Dollars in Targeted Case Management Services That Did Not Comply With Federal and State Requirements A-07-22-03253
- Updated: CIA Reportable Events
- Updated: CMP and Affirmative Exclusions
- Updated: Fraud Self-Disclosures
- Updated: Grant and Contractor Fraud Self-Disclosures
- 04-03-2024
- Nursing Home Residents With Endangering Behaviors and Mental Health Disorders May Be Vulnerable to Facility-Initiated Discharges OEI-01-18-00252
- Concerns Remain About Safeguards To Protect Residents During Facility-Initiated Discharges From Nursing Homes OEI-01-18-00251
- ACF Has Enhanced Some Cybersecurity Controls Over the Unaccompanied Children Portal and Data But Improvements Are Needed A-18-22-03200
- A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees' Access to Care OEI-02-22-00050
- 04-02-2024
- Administration for Children and Families Data Hosted in Certain Cloud Information Systems May Be at a High Risk of Compromise A-18-22-08020
- Fiscal Year 2018 and 2019 Biomedical Advanced Research and Development Authority Appropriations May Not Have Been Used for Their Intended Purpose in Accordance With Federal Requirements A-03-20-03002
- 04-01-2024
- New Jersey Significantly Improved Its Oversight of Medicaid Adult Partial Care Services Except for Those Provided Using Telehealth During the COVID-19 Public Health Emergency A-02-22-01007
- IHS Did Not Coordinate Supply Service Center Operations Before and During the COVID-19 Pandemic and Should Consider Upgrading Supply Centers' Inventory Management Systems and Implementing Policies and Procedures To Enhance Coordination and Alignment A-07-22-04131
- 03-29-2024
- New Jersey Complied With Federal Regulations When Implementing Programs Under SAMHSA's Opioid Response Grants, But Did Not Meet Its Program Services Goals A-02-22-02002
- 03-28-2024
- CMS Did Not Ensure That Selected States Complied With Medicaid Managed Care Mental Health and Substance Use Disorder Parity Requirements A-02-22-01016
- 03-27-2024
- The Thailand Ministry of Public Health Managed PEPFAR Funds According to Federal Regulations but Internal Controls Could Be Improved A-04-21-01021
- Delaware Made Capitation Payments to Medicaid Managed Care Organizations After Enrollees' Deaths A-03-22-00205
- 03-26-2024
- HHS-OIG Cybersecurity Toolkit: Cybersecurity Considerations For HHS's Rapid Rollout of Information Systems
- 03-25-2024
- Updated: CMP and Affirmative Exclusions
- 03-21-2024
- New Video: HHS-OIG's Perspective on Managed Care
- 03-19-2024
- Utah MMIS and E&E System Had Adequate Security Controls In Place, but Improvements Are Needed A-18-21-09001
- South Carolina MMIS and E&E System Security Controls Were Adequate, but Some Improvements Are Needed A-18-22-09005
- 03-18-2024
- NEW HHS-OIG Impact Brief: Medicare Advantage Prior Authorization
- 03-15-2024
- Updated: Work Plan
- 03-14-2024
- Medicaid Fraud Control Units Fiscal Year 2023 Annual Report
- 03-13-2024
- IG Grimm Named Among Top Women Leaders in Health Care
- Kansas's Medicaid Estate Recovery Program Was Cost Effective, but Kansas Did Not Always Follow Its Procedures, Which Could Have Resulted in Reduced Recoveries A-07-22-03254
- Pennsylvania Improperly Claimed $551 Million in Medicaid Funds for Its School-Based Program A-02-21-01011
- 03-12-2024
- Issue Brief: Insights from OIG's Work on the Office of Refugee Resettlement's Efforts to Care for Unaccompanied Children OEI-09-23-00440
- 03-11-2024
- FY 2025 Congressional Budget Justification
- Updated: CMP and Affirmative Exclusions
- 03-08-2024
- LEIE Database Updated with February 2024 Exclusions and Reinstatements
- 03-07-2024
- HRSA Made Some Potential Overpayments to Providers Under the Phase 2 General Distribution of the Provider Relief Fund Program A-09-22-06001
- Updated: Fraud Self-Disclosures
- 03-06-2024
- Consumer Alert: Urinary Catheter Scams
- Data Snapshot: Biosimilar Cost and Use Trends in Medicare Part B OEI-05-22-00141
- 02-29-2024
- Lessons Learned During the Pandemic Can Help Improve Care in Nursing Homes OEI-02-20-00492
- 02-26-2024
- Advisory Opinion 24-01 Favorable opinion regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.
- 02-22-2024
- New: Single Audits - Information and Oversight Activities
- 02-20-2024
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That MediGold (Contract H3668) Submitted to CMS A-07-20-01198
- Findings of Whistleblower Retaliation by Indian Health Service Contractor Management
- Updated: Connecticut State False Claims Act Review Letter
- 02-16-2024
- Report to Congress on the Reported Impact of Discarded-Drug Refunds on Biosimilar Biological Products A-06-23-04003
- 02-15-2024
- Gaps in Sponsor Screening and Followup Raise Safety Concerns for Unaccompanied Children OEI-07-21-00250
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2023 OEI-03-24-00050
- Updated: Work Plan
- 02-14-2024
- Medicare Generally Paid for Evaluation and Management Services Provided via Telehealth During the First 9 Months of the COVID-19 Public Health Emergency That Met Medicare Requirements A-01-21-00501
- Updated: Corporate Integrity Agreements
- 02-08-2024
- NIH Generally Implemented System Controls Over the Sequence Read Archive But Some Improvements Needed A-18-22-03300
- LEIE Database Updated with January 2024 Exclusions and Reinstatements
- Updated: Fraud Self-Disclosures
- 02-06-2024
- Colorado Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-07-22-07009
- Job Opening: ACRB Deputy Branch Chief
- 02-02-2024
- Updated: Corporate Integrity Agreements
- 01-29-2024
- Updated: CMP and Affirmative Exclusions
- 01-26-2024
- Updated: Fraud Risk Indicator
- 01-22-2024
- Updated: CMP and Affirmative Exclusions
- 01-19-2024
- HHS-OIG Issues Notice of Exclusion to Founder and CEO of Theranos, Inc.
- 01-18-2024
- Updated: Corporate Integrity Agreements
- 01-16-2024
- Two Tribes in Oklahoma and Their Health Programs Did Not Meet All Federal and Tribal Requirements for Background Investigations on Individuals in Contact With Indian Children A-01-20-01505
- Updated: Work Plan
- 01-12-2024
- CDC Has Improved the Nursing Homes Reporting Process for COVID-19 Data in NHSN, but Challenges Remain OEI-06-22-00030
- Updated: Corporate Integrity Agreements
- Updated: Fraud Self-Disclosures
- Updated: Grant and Contractor Fraud Self-Disclosures
- 01-11-2024
- Independent Attestation Review: Substance Abuse and Mental Health Services Administration Fiscal Year 2023 Detailed Accounting Report and Budget Formulation Compliance Report for National Drug Control Activities and Accompanying Required Assertions A-03-24-00352
- Independent Attestation Review: Indian Health Service Fiscal Year 2023 Detailed Accounting Report and Budget Formulation Compliance Report for National Drug Control Activities, and Accompanying Required Assertions A-03-24-00351
- Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings A-04-24-02041
- 01-10-2024
- LEIE Database Updated with December 2023 Exclusions and Reinstatements
- Job Opening: ACRB Deputy Branch Chief
- 01-09-2024
- Oklahoma Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-06-22-09007
- Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-23-00637
- Cahaba Safeguard Administrators, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2020 A-07-23-00631
- Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-23-00635
- Cahaba Government Benefits Administrators, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-23-00634
- Cahaba Government Benefits Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-23-00636
- 01-05-2024
- Cahaba Government Benefits Administrators, LLC, Properly Updated the Medicare Segment Pension Assets and Overstated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of December 31, 2018 A-07-22-00627
- 01-03-2024
- Advisory Opinion 23-12 Favorable opinion regarding a one-time, voluntary redemption offer to physician partners reaching age 67 to have their partnership units repurchased by a partnership over a 2-year period, contingent upon the physician partners' agreement to retire from the practice of medicine.
- Advisory Opinion 23-13 Favorable opinion regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.
- Advisory Opinion 23-14 Favorable opinion regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.
- Advisory Opinion 23-15 Favorable opinion regarding a physician consulting company's proposal to offer physician practices that are current customers of the company certain gift cards for referring potential new physician practice customers.
August 2024
July 2024
June 2024
May 2024
April 2024
March 2024
February 2024
January 2024
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December
- 12-29-2023
- Findings of Whistleblower Retaliation by Health Resources and Services Administration Grantee
- Ohio Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-05-22-00019
- 12-27-2023
- Advisory Opinion 23-11 Favorable opinion regarding the proposed subsidization of certain Medicare cost-sharing obligations in the context of a clinical trial.
- 12-22-2023
- Medicare Part B Spending on Clinical Diagnostic Laboratory Tests in 2022 OEI-09-23-00350
- 12-21-2023
- California Did Not Comply With Requirements for Documenting Psychotropic and Opioid Medications Prescribed for Children in Foster Care A-05-22-00007
- 12-20-2023
- Advisory Opinion 23-10 Favorable opinion regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.
- HHS Did Not Ensure Foundational Cybersecurity Controls Were in Place Prior to Implementation of HHS Protect and Use of a Contractor's Cloud Service A-18-20-06800R
- Updated: Corporate Integrity Agreements
- 12-19-2023
- The National Institutes of Health Did Not Receive 81 of 109 Required Audit Reports for Foreign Grant Recipients A-05-21-00019
- NIH Did Not Consistently Meet Federal Single Audit Requirements for Extramural Grants OEI-04-21-00160
- 12-18-2023
- The Provider Relief Fund Helped Select Nursing Homes Maintain Services During the COVID 19 Pandemic, but Some Found Guidance Difficult to Use OEI-06-22-00040
- Advisory Opinion 23-09 Favorable opinion regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.
- 12-15-2023
- Updated: Work Plan
- Medicare Generally Paid Acute-Care Hospitals for Inpatient Stays for Medicare Enrollees Diagnosed With COVID-19 in Accordance With Federal Requirements A-09-21-03009
- 12-14-2023
- The Consistently Low Percentage of Medicare Enrollees Receiving Medication to Treat Their Opioid Use Disorder Remains a Concern OEI-02-23-00250
- Toolkit: To Help Decrease Improper Payments in Medicare Advantage Through the Identification of High-Risk Diagnosis Codes A-07-23-01213
- 12-12-2023
- Washington State Did Not Ensure That Selected Nursing Homes Complied With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-09-22-02006
- 12-11-2023
- Updated: Corporate Integrity Agreements
- Updated: Fraud Self-Disclosures
- 12-08-2023
- LEIE Database Updated with November 2023 Exclusions and Reinstatements
- Connecticut Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents A-01-21-00001
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2022 in Accordance With Federal Requirements A-04-23-03586
- 12-06-2023
- Louisiana Should Improve Its Oversight of Nursing Homes' Compliance With Requirements That Prohibit Employment of Individuals With Disqualifying Background Checks A-06-21-02000
- 12-04-2023
- Pennsylvania Implemented Our Prior Audit Recommendations for Critical Incidents Involving Medicaid Enrollees With Developmental Disabilities but Should Continue To Take Action To Reduce Unreported Incidents A-03-22-00202
- 12-01-2023
- Fall 2023 Semiannual Report to Congress
- HHS-OIG's Efforts Result in $3.44 Billion in Expected Recoveries, According to Latest Report
November
- 11-30-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That SelectCare of Texas, Inc. (Contract H4506), Submitted to CMS A-06-19-05002
- 11-28-2023
- Multiple States Made Medicaid Capitation Payments to Managed Care Organizations After Enrollees' Deaths A-04-21-09005
- Early Alert: Part B Payment Amount for Tezspire Included a Noncovered Self-Administered Version in 2023 OEI-BL-24-00030
- 11-27-2023
- The Risk of Misuse and Diversion of Buprenorphine for Opioid Use Disorder in Medicare Part D Continues to Appear Low: 2022 OEI-02-24-00130
- 11-22-2023
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2022 A-18-23-11300
- 11-21-2023
- Consumer Alert: Remote Patient Monitoring
- 11-20-2023
- Some of California's Substance Abuse Prevention and Treatment Block Grant Expenditures for Los Angeles County Did Not Comply With Federal and State Requirements A-09-21-01001
- Updated: Corporate Integrity Agreements
- 11-17-2023
- Kentucky Experienced Challenges in Meeting Federal and State Foster Care Program Requirements During the COVID-19 Pandemic A-06-22-07001
- 11-16-2023
- 2023 Top Management & Performance Challenges Facing HHS
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2023 OEI-03-24-00040
- 11-15-2023
- Updated: Work Plan
- 11-14-2023
- FY 2022 Health Care Fraud and Abuse Control Program Report
- 11-13-2023
- The Food and Drug Administration Needs To Improve the Premarket Tobacco Application Review Process for Electronic Nicotine Delivery Systems To Protect Public Health A-06-22-01002
- Pennsylvania Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-03-22-00206
- 11-09-2023
- LEIE Database Updated with October 2023 Exclusions and Reinstatements
- CMS Can Do More To Leverage Medicare Claims Data To Identify Unreported Incidents of Potential Abuse or Neglect A-01-22-00501
- 11-07-2023
- Updated: Corporate Integrity Agreements
- Updated: Fraud Self-Disclosures
- Updated: CMP and Affirmative Exclusions
- 11-06-2023
- NEW: General Compliance Program Guidance
- Congressional Mandate: Part B Payment Amounts for Two Drugs Included Noncovered Self Administered Versions in 2022 OEI-BL-22-00380
- 11-03-2023
- Noridian Healthcare Solutions Reopened and Corrected Cost Report Final Settlements To Collect $11 Million in Net Overpayments That Had Been Made to Medicare Providers A-06-22-05000
- 11-01-2023
- HHS's Oversight of Automatic Provider Relief Fund Payments Was Generally Effective but Improvements Could Be Made A-02-20-01025
October
- 10-30-2023
- New York City Department of Health and Mental Hygiene Charged Some Unallowable Costs to Its CDC COVID-19 Award A-04-22-02035
- Medicare Advantage Compliance Audit of Diagnosis Codes That CarePlus Health Plans, Inc. (Contract H1019) Submitted to CMS A-04-19-07082
- 10-27-2023
- CDC's Internal Control Weaknesses Led to Its Initial COVID-19 Test Kit Failure, but CDC Ultimately Created a Working Test Kit A-04-20-02027
- 10-25-2023
- Advisory Opinion 23-08 Unfavorable opinion regarding a cochlear implant manufacturer's proposal to offer and provide a free compatible hearing aid to certain patients, including Federal health care program beneficiaries, who receive one of the cochlear implants it manufactures.
- 10-24-2023
- States Face Ongoing Challenges in Meeting Third-Party Liability Requirements for Ensuring That Medicaid Functions as the Payer of Last Resort A-05-21-00013
- 10-23-2023
- Updated: Fraud Risk Indicator
- Updated: CMP and Affirmative Exclusions
- 10-20-2023
- South Dakota MMIS and E&E System Security Controls Were Partially Effective and Improvements Are Needed A-18-21-09004
- 10-19-2023
- Mississippi Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-21-06103
- 10-18-2023
- The Strategic National Stockpile Was Not Positioned To Respond Effectively to the COVID-19 Pandemic A-04-20-02028
- 10-16-2023
- Updated: Work Plan
- 10-13-2023
- Advisory Opinion 23-07 Favorable opinion regarding an employer's proposal to pay bonuses to its employed physicians based on net profits derived from certain procedures performed by the physicians.
- Updated: Annual Inflation Updates to the Annual Cap on Patient Engagement Tools and Supports Under 42 CFR § 1001.952(hh)
- 10-11-2023
- Medicare Could Save Millions if It Implements an Expanded Hospital Transfer Payment Policy for Discharges to Postacute Care A-01-21-00504
- 10-10-2023
- LEIE Database Updated with September 2023 Exclusions and Reinstatements
- 10-06-2023
- Illinois State University's Management of NIH Awards Complied With Federal and Financial Conflict of Interest Requirements A-05-20-00033
- Updated: Corporate Integrity Agreements
- Updated: Fraud Self-Disclosures
- 10-05-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Aetna, Inc. (Contract H5521) Submitted to CMS A-01-18-00504
- 10-03-2023
- New Jersey Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-02-22-01004
- Updated: Corporate Integrity Agreements
September
- 09-29-2023
- Many Medicaid Enrollees with Opioid Use Disorder Were Treated with Medication; However, Disparities Present Concerns OEI-BL-22-00260
- District of Columbia Medicaid Fraud Control Unit: 2022 Onsite Review OEI-06-22-00420
- 09-28-2023
- Advisory Opinion 23-06 Unfavorable opinion regarding a laboratory company's proposal to purchase anatomic pathology services from third-party laboratories.
- 09-27-2023
- Texas Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State A-05-22-00018
- Home Health Agencies Rarely Furnished Services Via Telehealth Early in the COVID-19 Public Health Emergency A-05-21-00026
- CDC Provided Oversight and Assistance; However, ELC Recipients Still Faced Challenges in Implementing COVID-19 Screening Testing Programs A-05-22-00010
- 09-26-2023
- Four States Reviewed Received Increased Medicaid COVID-19 Funding Even Though They Terminated Some Enrollees' Coverage for Unallowable or Potentially Unallowable Reasons A-06-21-09002
- HRSA Had An Effective Process To Identify And Monitor High-Risk Health Centers That Received COVID-19 Grant Funds A-01-21-01503
- Medicare Advantage Compliance Audit of Diagnosis Codes That Health Net of California, Inc. (Contract H0562) Submitted to CMS A-09-18-03007
- 09-25-2023
- Alabama Did Not Always Invoice Rebates to Manufacturers for Pharmacy and Physician-Administered Drugs A-04-21-08090
- 09-22-2023
- Employee Profile: Patrick Neubert
- 09-21-2023
- FDA Could Take Stronger Enforcement Action Against Tobacco Retailers With Histories of Sales to Youth and Other Violations OEI-01-20-00240
- Supplemental Data on Tobacco Retailer Inspections OEI-01-20-00242
- Review of Personnel Shortages in Federal Health Care Programs During the COVID-19 Pandemic
- 09-20-2023
- New York Did Not Ensure That a Managed Care Organization Complied With Requirements for Denying Prior Authorization Requests A-02-21-01016
- Key Strategies That States Used for Managing Medicaid and Marketplace Enrollment During the COVID-19 PHE
- 09-19-2023
- Updated:
- 09-18-2023
- 2024 Spring Health Care Fraud And Abuse Legal Internship
- 09-15-2023
- Updated: Work Plan
- Amerigroup Iowa's Prior Authorization and Appeal Processes Were Effective, but Improvements Can Be Made A-07-22-07007
- 09-14-2023
- Kentucky Did Not Always Invoice Manufacturers for Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-04-22-07102
- Novitas Solutions, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals A-07-23-00633
- 09-13-2023
- Puerto Rico Claimed Over $7 Million in Federal Reimbursement for Medicaid Capitation Payments Made on Behalf of Enrollees Who Were or May Have Been Deceased A-02-21-01005
- Puerto Rico Claimed More Than $500 Thousand in Unallowable Medicaid Managed Care Payments for Enrollees Assigned More Than One Identification Number A-02-21-01004
- The Substance Abuse and Mental Health Services Administration Did Not Ensure That Clinics Fully Complied With Federal Requirements When Awarding and Monitoring Certified Community Behavioral Health Clinic Expansion Grants A-02-21-02010
- 09-12-2023
- Risk Assessment of the Administration for Children and Families' Purchase Card Program for Fiscal Year 2021 A-04-22-06262
- CDC's Vaccines for Children Program Recipients Did Not Conduct Site Visits at Some Providers as Required A-09-22-01000
- Medicare Improperly Paid Acute-Care Hospitals for Inpatient Claims Subject to the Post-Acute-Care Transfer Policy Over a 4-Year Period, but CMS's System Edits Were Effective in Reducing Improper Payments by the End of the Period A-09-23-03016
- 09-11-2023
- Updated: Corporate Integrity Agreements
- 09-08-2023
- Georgia Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-04-22-08093
- Minnesota Medicaid Fraud Control Unit: 2022 Inspection OEI-06-22-00430
- 09-07-2023
- Home Health Agencies Failed To Report Over Half of Falls With Major Injury and Hospitalization Among Their Medicare Patients OEI-05-22-00290
- LEIE Database Updated with August 2023 Exclusions and Reinstatements
- 09-06-2023
- Nursing Homes Reported Wide-Ranging Challenges Preparing for Public Health Emergencies and Natural Disasters OEI-06-22-00100
- 09-05-2023
- Florida Did Not Refund $106 Million Federal Share of Medicaid Managed Care Rebates It Received for Calendar Years 2015 Through 2020 A-04-22-04089
- Risk Assessment of the Administration for Children and Families' Travel Card Program for Fiscal Year 2021 A-04-22-06263
- Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria Inspectors General Coordinated PEPFAR Oversight Plan Fiscal Year 2024 U.S. Department of Health and Human Services, Office of Inspector General A-04-23-01027
- 09-01-2023
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2021 Average Sales Prices OEI-03-23-00120
- Updated: Corporate Integrity Agreements
August
- 08-31-2023
- One Quarter of Medicaid Enrollees with HIV May Not Have Received Critical Services in 2021 OEI-05-22-00240
- Widespread Pandemic Disruption Spurred Innovation to State Paternity Establishment Practices OEI-06-21-00150
- 08-28-2023
- Featured Topic: Managed Care
- 08-18-2023
- Advisory Opinion 23-05 Unfavorable opinion regarding a company's proposal to assist physicians who perform surgeries for which the company's services are used with the formation and operation of a turnkey physician-owned entity that would perform those same services.
- Medicare Made $17.8 Million in Potentially Improper Payments for Opioid-Use-Disorder Treatment Services Furnished by Opioid Treatment Programs A-09-22-03005
- 08-16-2023
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2023 OEI-03-23-00100
- 08-15-2023
- Updated: Work Plan
- Texas Inappropriately Claimed Nearly $1.8 Million in Federal Medicaid Funds for Private Medicaid Management Information System Contractor Costs A-06-19-09003
- 08-14-2023
- Updated: Corporate Integrity Agreements
- 08-11-2023
- Medicare Paid Independent Organ Procurement Organizations Over Half a Million Dollars for Professional and Public Education Overhead Costs That Did Not Meet Medicare Requirements A-09-21-03020
- Office of Inspector General's Partnership With the Commonwealth of Massachusetts Office of the State Auditor: Office of Medicaid (MassHealth)-Review of Capitation Payments A-01-22-00002
- 08-10-2023
- LEIE Database Updated with July 2023 Exclusions and Reinstatements
- States With Separate Children's Health Insurance Programs Could Have Collected an Estimated $641 Million Annually If States Were Required To Obtain Rebates Through the Medicaid Drug Rebate Program A-07-22-06106
- 08-04-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Presbyterian Health Plan, Inc. (Contract H3204) Submitted to CMS A-07-20-01197
- First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs A-07-23-00630
- First Coast Service Options, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals A-07-23-00632
- First Coast Service Options, Inc., Overstated Its Medicare Segment Postretirement Benefit Assets as of January 1, 2019 A-07-23-00629
- Updated:
- 08-03-2023
- Employee Profile: Demetrius Martinez
- First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Supplemental Executive Retirement Plan Costs A-07-22-00626
- Updated: Corporate Integrity Agreements
- 08-02-2023
- Findings of Whistleblower Retaliation Health Resources and Services Administration Grantee Management Official
- Telehealth During 2020 Helped Ensure End-Stage Renal Disease Patients Received Care, But Limited Information Related to Telehealth Was Documented A-05-22-00015
- New York Improved Its Monitoring of Medicaid Community Rehabilitation Services But Still Claimed Improper Federal Medicaid Reimbursement Totaling $20 Million A-02-22-01011
- Medicare Paid $30 Million for Accumulated Repair Costs That Exceeded the Federally Recommended Cost Limit for Wheelchairs During Their 5-Year Reasonable Useful Lifetime A-09-22-03003
July
- 07-24-2023
- Virginia Made Capitation Payments to Medicaid Managed Care Organizations After Enrollees' Deaths A-03-22-00203
- 07-21-2023
- Although IHS Allocated COVID-19 Testing Funds To Meet Community Needs, It Did Not Ensure That the Funds Were Always Used in Accordance With Federal Requirements A-07-20-04123
- Updated: CMP and Affirmative Exclusions
- 07-20-2023
- Updated: Corporate Integrity Agreements
- 07-19-2023
- High Rates of Prior Authorization Denials by Some Plans and Limited State Oversight Raise Concerns About Access to Care in Medicaid Managed Care OEI-09-19-00350
- Florida Did Not Comply With Requirements for Documenting Psychotropic and Opioid Medications Prescribed for Children in Foster Care A-05-22-00009
- 07-18-2023
- HRSA Made COVID-19 Uninsured Program Payments to Providers on Behalf of Individuals Who Had Health Insurance Coverage and for Services Unrelated to COVID-19 A-02-21-01013
- Updated: Fraud Risk Indicator
- 07-17-2023
- Updated: Work Plan
- Targeted Provider Relief Funds Allocated to Hospitals Had Some Differences with Respect to the Ethnicity and Race of Populations Served OEI-05-20-00580
- 07-12-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Excellus Health Plan, Inc. (Contract H3351) Submitted to CMS A-07-20-01202
- 07-11-2023
- Advisory Opinion 23-04 (Favorable) Regarding: (i) the use of a health technology company's online health care directory by Federal health care program beneficiaries to search for and book medical appointments with providers and the display of sponsored advertisements to Federal health care program beneficiaries on the directory and certain third-party websites; and (ii) certain proposed changes to the functionality of the directory.
- Updated:
- 07-10-2023
- LEIE Database Updated with June 2023 Exclusions and Reinstatements
- Updated Interactive Maps: Office of Audit Services Opioid Reviews
- 07-07-2023
- Updated: Corporate Integrity Agreements
- 07-06-2023
- Adverse Events Toolkits: Medical Review Methodology and Clinical Guidance for Identifying Patient Harm
- Part D Plans Generally Include Drugs Commonly Used by Dual-Eligible Enrollees: 2023 OEI-05-23-00130
- Tracking Pandemic Relief Funds that Went to Local Communities Reveals Persistent Data Gaps and Data Reliability Issues
- 07-05-2023
- Updated: Information Blocking Final Rule
June
- 06-29-2023
- Noridian Healthcare Solutions, LLC, Made $8.8 Million in Improper Monthly Capitation Payments to Physicians and Qualified Nonphysician Practitioners in Jurisdiction E for Certain Services Related to End-Stage Renal Disease A-09-21-03016
- 06-28-2023
- 2023 Nationwide Health Care Fraud Enforcement Action
- A Resource Guide for Using Medicare's Enrollment Race and Ethnicity Data OEI-02-21-00101
- 06-27-2023
- Information Blocking Final Rule
- 06-23-2023
- CMS's Oversight of Medicare Payments for the Highest Paid Molecular Pathology Genetic Test Was Not Adequate To Reduce the Risk of up to $888 Million in Improper Payments A-09-22-03010
- Updated: Corporate Integrity Agreements
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- 06-21-2023
- 2022 Performance Data for the Senior Medicare Patrol Projects OEI-02-23-00150
- 06-20-2023
- Updated: Corporate Integrity Agreements
- 06-15-2023
- Updated: Work Plan
- Updated: Corporate Integrity Agreements
- 06-13-2023
- Alaska Experienced Challenges in Meeting Federal and State Foster Care Program Requirements During the COVID-19 Pandemic A-06-21-07006
- 06-08-2023
- LEIE Database Updated with May 2023 Exclusions and Reinstatements
- 06-07-2023
- Employee Profile: Lauren Buss
- Updated: Corporate Integrity Agreements
- 06-06-2023
- NIH Should Improve Its Management of Contracts for the Acquisition of Information Technology A-18-21-11500
- Updated:
- 06-02-2023
- Spring 2023 Semiannual Report to Congress
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Keystone Health Plan East, Inc. (Contract H3952) Submitted to CMS A-03-20-00001
- Saint Louis University's Management of NIH Grant Awards Did Not Comply With All Federal Requirements but Complied With Financial Conflict of Interest Requirements A-07-20-05127
May
- 05-31-2023
- Medicare Paid Millions More for Physician Services at Higher Nonfacility Rates Rather Than at Lower Facility Rates While Enrollees Were Inpatients of Facilities A-04-21-04084
- Vermont Complied With Regulations When Implementing Programs Under SAMHSA's Opioid Response Grants, but Claimed Unallowable Expenditures A-01-20-01501
- Florida Did Not Ensure That Some Providers Complied With Requirements For Determining Eligibility For Its Projects for Assistance in Transition From Homelessness Program A-02-21-02008
- Updated: General Questions Regarding Certain Fraud and Abuse Authorities
- 05-30-2023
- Maryland MMIS and E&E System Security Controls Were Partially Effective and Improvements Are Needed A-18-21-09003
- 05-25-2023
- The Office of Refugee Resettlement Needs To Improve Its Oversight Related to the Placement and Transfer of Unaccompanied Children A-06-20-07002
- The Centers for Medicare & Medicaid Services Should Improve Preventative and Detective Controls To More Effectively Mitigate the Risk of Compromise A-18-20-08001
- 05-24-2023
- Video: Assistant IG for Evaluation and Inspections Erin Bliss Testifies Before the Committee on Aging: "Residents at Risk: The Strained Nursing Home Inspection System and the Need to Improve Oversight, Transparency, and Accountability"
- 05-23-2023
- Video: Testimony of Megan Tinker, Chief of Staff, before the U.S. Senate Homeland Security & Governmental Affairs Committee: "Examining Health Care Denials and Delays in Medicare Advantage"
- Seventeen of Thirty Selected Health Centers Did Not Use or May Not Have Used Their HRSA COVID-19 Supplemental Grant Funding in Accordance With Federal Requirements A-02-21-02005
- 05-22-2023
- Employee Profile: Rochelle Wong
- Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for the Fiscal Year 2022 A-17-23-52000
- 05-19-2023
- Montana Generally Complied With Requirements for Telehealth Services During the COVID-19 Pandemic A-07-21-03250
- 05-18-2023
- Testimony of Erin Bliss, Assistant Inspector General for Evaluation and Inspections, before the U.S. Senate Special Committeeon Aging: "Residents at Risk: The Strained Nursing Home Inspection System and the Need to Improve Oversight, Transparency, and Accountability"
- The Risk of Misuse and Diversion of Buprenorphine for Opioid Use Disorder Appears to Be Low in Medicare Part D OEI-02-22-00160
- Massachusetts MMIS and E&E System Security Controls Were Generally Effective, but Some Improvements Are Needed A-18-20-08003
- 05-17-2023
- Testimony of Megan Tinker, Chief of Staff, before the U.S. Senate Homeland Security & Governmental Affairs Committee: "Examining Health Care Denials and Delays in Medicare Advantage"
- 05-16-2023
- Consumer Alert: Fraud Schemes Targeting Native American Communities in Behavioral Health Treatment Centers
- 05-15-2023
- Updated: Work Plan
- State Agencies Can Improve Their Reporting of Children Missing From Foster Care to Law Enforcement for Entry Into the National Crime Information Center Database as Required by Federal Statute A-07-21-06104
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2022 OEI-03-23-00090
- 05-12-2023
- Updated: CMP and Affirmative Exclusions
- 05-10-2023
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2022 A-18-22-11200
- LEIE Database Updated with April 2023 Exclusions and Reinstatements
- 05-09-2023
- Updated:
- 05-04-2023
- Medicare Improperly Paid Providers for Some Psychotherapy Services, Including Those Provided via Telehealth, During the First Year of the COVID-19 Public Health Emergency A-09-21-03021
- The Office of Refugee Resettlement Needs To Improve Its Practices for Background Checks During Influxes A-06-21-07003
- Updated: Corporate Integrity Agreements
- 05-02-2023
- Inspector General Grimm HCCA 27th Annual Compliance Institute Keynote
April
- 04-26-2023
- Medicare Could Have Saved Up To $128 Million Over 5 Years if CMS Had Implemented Controls To Address Duplicate Payments for Services Provided to Individuals With Medicare and Veterans Health Administration Benefits A-09-22-03004
- 04-24-2023
- Toolkit: Analyzing Telehealth Claims to Assess Program Integrity Risks OEI-02-20-00723
- Crow/Northern Cheyenne Hospital—an IHS-Operated Health Facility—Did Not Timely Conduct Required Background Checks of Staff and Supervise Certain Staff A-02-21-02004
- Compliance Guidance Update
- Modification of Advisory Opinion 20-04 (Regarding a charitable organization's proposal to purchase or receive donations of unpaid medical debt owed by qualifying patients from certain types of health care providers and then forgive that debt.)
- 04-21-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HumanaChoice (Contract H6609) Submitted to CMS A-05-19-00013
- 04-20-2023
- 2023 Nationwide COVID-19 Health Care Fraud Enforcement Action
- 04-19-2023
- Updated: CMP and Affirmative Exclusions
- 04-18-2023
- Testimony of Christi A. Grimm, Inspector General, United States House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, Testimony to "Insights from the HHS Inspector General on Oversight of Unaccompanied Minors, Grant Management, and CMS"
- 04-17-2023
- Updated: Work Plan
- 04-14-2023
- Updated: Fraud Risk Indicator
- 04-12-2023
- CMS Did Not Accurately Report on Care Compare One or More Deficiencies Related to Health, Fire Safety, and Emergency Preparedness for an Estimated Two-Thirds of Nursing Homes A-09-20-02007
- 04-10-2023
- LEIE Database Updated with March 2023 Exclusions and Reinstatements
- 04-07-2023
- Updated: Corporate Integrity Agreements
- 04-06-2023
- Updated:
- 04-04-2023
- Employee Profile: Curtis Roy
- 04-03-2023
- Rhode Island Medicaid Fraud Control Unit: 2022 Inspection OEI-07-22-00370
March
- 03-31-2023
- Texas Could Not Support the Permissibility of the Funds Used as the State Share of the Medicaid Delivery System Reform Incentive Payment Program A-06-17-09004
- 03-30-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cigna-HealthSpring Life & Health Insurance Company, Inc. (Contract H4513) Submitted to CMS A-07-19-01192
- 03-29-2023
- Advisory Opinion 23-03 (Regarding a proposal to provide a prepaid card to certain individuals, including Federal health care program beneficiaries, to encourage those individuals to return the sample collection kit associated with a colorectal cancer screening test.)
- Missouri's Oversight of Certified Individualized Supported Living Provider Health and Safety Could Be Improved in Some Areas A-07-21-03247
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That MCS Advantage, Inc. (Contract H5577) Submitted to CMS A-02-20-01008
- 03-28-2023
- Featured Topic: Hospice
- 03-27-2023
- Maryland's Child Support Administration Generally Claimed Administrative Costs That Were Allowable and Allocable A-01-22-02500
- 03-24-2023
- Medicare Improperly Paid Physicians an Estimated $30 Million for Spinal Facet-Joint Interventions A-09-22-03006
- 03-21-2023
- The District of Columbia Has Taken Significant Steps To Ensure Accountability Over Amounts Managed Care Organizations Paid to Pharmacy Benefit Managers A-03-20-00200
- 03-20-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Geisinger Health Plan (Contract H3954) Submitted to CMS A-09-21-03011
- 03-17-2023
- Georgia Did Not Comply With Federal Waiver and State Requirements at All 20 Adult Day Health Care Facilities Reviewed A-04-22-00134
- 03-15-2023
- IG Grimm RISE Conference Speech - OIG's Vantage on Medicare Advantage
- Updated: Work Plan
- Georgia Did Not Always Invoice Rebates to Manufacturers for Pharmacy and Physician-Administered Drugs A-04-21-08089
- 03-14-2023
- Some Skin Substitute Manufacturers Did Not Comply with New ASP Reporting Requirements OEI-BL-23-00010
- 03-13-2023
- FY 2024 Congressional Budget Justification
- Medicare Improperly Paid Physicians for Epidural Steroid Injection Sessions A-07-21-00618
- Michigan MMIS and E&E Systems Security Controls Were Generally Effective, but Some Improvements Are Needed A-18-20-08004
- 03-10-2023
- OIG's COVID-19 Public Health Emergency Flexibilities End on May 11, 2023 Upon Expiration of the COVID-19 Public Health Emergency Declaration
- Medicaid Fraud Control Units Fiscal Year 2022 Annual Report OEI-09-23-00190
- LEIE Database Updated with February 2023 Exclusions and Reinstatements
- 03-08-2023
- Findings of Whistleblower Retaliation by Army and Contractor Jacobs Technologies Management Officials
- Updated:
- 03-07-2023
- Florida Did Not Invoice Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-04-21-07098
- 03-06-2023
- Women's History Month: The Legacy of IG June Gibbs-Brown
- 03-03-2023
- State Agencies Did Not Always Ensure That Children Missing From Foster Care Were Reported to the National Center for Missing and Exploited Children in Accordance With Federal Requirements A-07-21-06102
- Updated: Corporate Integrity Agreements
- 03-02-02023
- The Inability To Identify Denied Claims in Medicare Advantage Hinders Fraud Oversight OEI-03-21-00380
- Medicare Part D Plan Sponsors and CMS Did Not Ensure That Transmucosal Immediate-Release Fentanyl Drugs Were Dispensed Only to Beneficiaries Who Had a Cancer Diagnosis A-09-20-03033
- 03-01-2023
- Medicare Could Have Saved up to $216 Million Over 5 Years if Program Safeguards Had Prevented At-Risk Payments for Definitive Drug Testing Services A-09-21-03006
February
- 02-28-2023
- Updated List: High Risk - Heightened Scrutiny
- Advisory Opinion 23-02 (Regarding a program to provide a drug for free, for a limited time, to patients who experience a delay in their insurance approval process for the drug.)
- 02-27-2023
- Missouri Claimed Federal Medicaid Reimbursement for Tens of Millions in Consumer-Directed Personal Care Assistance Services That Did Not Comply With Federal and State Requirements A-07-20-03243
- 02-24-2023
- Fraud Alert: Scammers Steal Money From the Public Through Fake HHS Websites and Social Media Schemes
- Florida Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State A-05-21-00028
- 02-23-2023
- The Health Resources and Services Administration Should Improve Preventive and Detective Controls To More Effectively Mitigate the Risk of Compromise A-18-20-08200
- Advisory Opinion 23-01 (Regarding financial assistance for transportation, lodging, and meals provided by a drug manufacturer to financially needy pediatric patients and their caregiver(s) in connection with treatment with the manufacturer's drug.)
- 02-17-2023
- Employee Profile: Jasmyn Ferbish
- 02-15-2023
- Updated: Work Plan
- 02-14-2023
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2022 OEI-03-23-00080
- Updated: Fraud Self-Disclosures
- 02-13-2023
- Michigan Did Not Comply With Requirements for Documenting Psychotropic and Opioid Medications Prescribed for Children in Foster Care A-05-21-00030
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- 02-10-2023
- LEIE Database Updated with January 2023 Exclusions and Reinstatements
- 02-08-2023
- North Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-21-07002
- Updated: Corporate Integrity Agreements
- 02-07-2023
- Technical Assistance Brief: Implementation of Inflation-Indexed Rebates for Part B Drugs OEI-BL-23-00170
January
- 01-31-2023
- Early Challenges Highlight Areas for Improvement in COVID-19 Vaccination Programs OEI-04-21-00190
- Challenges With Vaccination Data Hinder State and Local Immunization Program Efforts To Combat COVID-19 OEI-05-22-00010
- Updated: Fraud Risk Indicator
- 01-27-2023
- Greater Bergen Community Action, Inc., Did Not Manage Its Head Start Awards in Accordance With Federal and State Requirements A-02-19-02008
- 01-25-2023
- Operation Nightingale Enforcement Action
- The National Institutes of Health and EcoHealth Alliance Did Not Effectively Monitor Awards and Subawards, Resulting in Missed Opportunities to Oversee Research and Other Deficiencies A-05-21-00025
- 01-20-2023
- Employee Profile: Abbi Warmker
- Updated: Corporate Integrity Agreements
- Independent Attestation Review: National Institutes of Health Fiscal Year 2022 Detailed Accounting Submission and Budget Formulation Compliance Report for National Drug Control Activities, and Accompanying Required Assertions A-03-23-00351
- Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2022 Detailed Accounting Submission and Budget Formulation Compliance Report for National Drug Control Activities and Accompanying Required Assertions A-03-23-00352
- Independent Attestation Review: Food and Drug Administration Fiscal Year 2022 Detailed Accounting Submission and Budget Formulation Compliance Report for National Drug Control Activities and Accompanying Required Assertions A-03-23-00353
- 01-19-2023
- More Than a Thousand Nursing Homes Reached Infection Rates of 75 Percent or More in the First Year of the COVID-19 Pandemic; Better Protections Are Needed for Future Emergencies OEI-02-20-00491
- 01-18-2023
- ASPR Could Improve Its Oversight of the Hospital Preparedness Program To Ensure That Crisis Standards of Care Comply With Federal Nondiscrimination Laws A-01-21-01502
- 01-17-2023
- Updated: Work Plan
- Updated List: High Risk - Heightened Scrutiny
- FDA Should Improve Its Management of Contracts for the Acquisition of Information Technology A-18-21-11100
- 01-13-2023
- New Interactive: Recommendations Tracker
- 01-12-2023
- Updated: Fraud Self-Disclosures
- 01-10-2023
- LEIE Database Updated with December 2022 Exclusions and Reinstatements
- Updated: Corporate Integrity Agreements
- 01-09-2023
- WANTED: Fugitive Khalid A. Satary
- National Government Services, Inc., Understated Its Plan A Medicare Segment Pension Assets and Overstated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of December 31, 2018 A-07-22-00620
- National Government Services, Inc., Overstated Its Plan B Medicare Segment Pension Assets and Overstated Medicare's Share of the Medicare Segment Excess Pension Assets as of December 31, 2018 A-07-22-00621
- National Government Services, Inc., Overstated Its United Government Services, LLC, Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of December 31, 2018 A-07-22-00622
- National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-22-00623
- 01-06-2023
- Illinois Generally Complied With Requirements for Claiming Medicaid Reimbursement for Telehealth Payments During COVID-19 A-05-21-00035
- The Municipality of Manati Did Not Always Manage Its Head Start Disaster Assistance Awards in Accordance With Federal And Commonwealth Requirements A-04-20-02032
- Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings A-04-22-06265
- 01-05-2023
- Updated: Corporate Integrity Agreements
- 01-04-2023
- Updated: Corporate Integrity Agreements
- 01-03-2023
- Manufacturers May Need Additional Guidance To Ensure Consistent Average Sales Price Calculations OEI-BL-21-00330
- CMS Should Bolster Its Oversight of Manufacturer-Submitted Average Sales Price Data To Ensure Accurate Part B Drug Payments OEI-03-21-00390
-
December
- 12-28-2022
- Advisory Opinion 22-22 (Regarding a pharmaceutical manufacturer's proposal to provide up to a specified number of trial units of a long-acting antipsychotic drug to certain hospitals for inpatient use.)
- 12-27-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cigna-HealthSpring of Tennessee, Inc. (Contract H4454) Submitted to CMS A-07-19-01193
- 12-23-2022
- Advisory Opinion 22-21 (Regarding an arrangement in which a county and its department of public health's emergency medical services division sublease certain space and lease certain furniture and equipment to a private ambulance company that has been granted an exclusive contract for the provision of emergency ambulance transports in certain parts of the county.)
- 12-22-2022
- National Government Services, Inc., Claimed Some Unallowable Medicare Postretirement Benefit Plan Costs Through Its Incurred Cost Proposals A-07-22-00624
- National Government Services, Inc., Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals A-07-22-00625
- National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals A-07-22-00628
- 12-21-2022
- Keystone First Should Improve Its Procedures for Reviewing Service Requests That Require Prior Authorization A-03-20-00201
- Mandated Analysis of Home Health Service Utilization From January 2016 Through March 2022 A-05-20-00031
- Updated: Corporate Integrity Agreements
- 12-20-2022
- For Medicaid-Enrolled Children Diagnosed With Lead Toxicity in Five States, Documentation Reviewed for Diagnoses and Treatment Services Raises Concerns OEI-07-18-00370
- New Work Plan Item: Implementation of Inflation-Indexed Rebates for Part B Drugs
- 12-19-2022
- Medicare Part B Spending on Lab Tests Increased in 2021, Driven By Higher Volume of COVID-19 Tests, Genetic Tests, and Chemistry Tests OEI-09-22-00400
- Providers Did Not Always Comply With Federal Requirements When Claiming Medicare Bad Debts A-07-20-02825
- Advisory Opinion 22-20 (Regarding a hospital's utilization of its employed nurse practitioners to perform services that traditionally have been performed by a patient's attending physician in certain medical units.)
- 12-16-2022
- Intimate Partner Violence Screening and Referral Survey: FAQ
- 12-15-2022
- 2022 Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs
- Updated: Work Plan
- 12-14-2022
- Updated: Corporate Integrity Agreements
- 12-13-2022
- Updated: Corporate Integrity Agreements
- 12-12-2022
- The Centers for Medicare & Medicaid Services' Review Contractor Did Not Document Medicaid Managed Care Payment Review Determinations Made Under the Payment Error Rate Measurement Program A-04-21-09003
- 12-09-2022
- LEIE Database Updated with November 2022 Exclusions and Reinstatements
- 12-08-2022
- Updated: Corporate Integrity Agreements
- 12-07-2022
- FDA's Approach to Overseeing Online Tobacco Retailers Needs Improvement OEI-01-20-00241
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- Updated: Fraud Self-Disclosures
- 12-06-2022
- Labs With Questionably High Billing for Additional Tests Alongside COVID-19 Tests Warrant Further Scrutiny OEI-09-20-00510
- 12-05-2022
- Fall 2022 Semiannual Report to Congress
- 12-01-2022
- Insights on Telehealth Use and Program Integrity Risks Across Selected Health Care Programs During the Pandemic OEI-02-22-00150
November
- 11-25-2022
- Medicare Improperly Paid Physicians for Co-Surgery and Assistant-at-Surgery Services That Were Billed Without the Appropriate Payment Modifiers A-01-20-00503
- National Government Services, Inc., Accurately Calculated Hospice Cap Amounts but Did Not Collect All Cap Overpayments A-06-21-08004
- 11-23-2022
- Medicare Providers Did Not Always Comply With Federal Requirements When Billing for Advance Care Planning A-06-20-04008
- 11-22-2022
- Puerto Rico MMIS and E&E Systems Security Controls Were Generally Effective, but Some Improvements Are Needed A-18-20-08005
- 11-18-2022
- Updated: Corporate Integrity Agreements
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That BCBS of Rhode Island (Contract H4152) Submitted to CMS A-01-20-00500
- The Centers for Medicare & Medicaid Services' Review Contractors Generally Conducted Medicaid Fee-for-Service Claim Reviews for Selected States Under the Payment Error Rate Measurement Program in Accordance with Federal and State Requirements A-04-21-00132
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2022 OEI-03-23-00070
- 11-17-2022
- Long-Term Trends of Psychotropic Drug Use in Nursing Homes OEI-07-20-00500
- 11-16-2022
- 2022 Top Management and Performance Challenges Facing HHS
- 11-15-2022
- Updated: Work Plan
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That California Physicians' Service, Inc. (Contract H0504) Submitted to CMS A-09-19-03001
- 11-14-2022
- The Number of Beneficiaries Who Received Medicare Part B Clinical Laboratory Tests Decreased During the First 10 Months of the COVID-19 Pandemic A-09-21-03004
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- Updated: Fraud Self-Disclosures
- Findings of Whistleblower Retaliation by Administration for Children and Families Grantee Management Official
- 11-10-2022
- Employee Profile: Farooq Al-Farooq
- LEIE Database Updated with October 2022 Exclusions and Reinstatements
- Iowa Implemented Most of Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Major Incidents A-07-21-06105
- 11-08-2022
- Los DesafÃos Operativos Dentro de la Oficina de Reasentamiento de Refugiados y el Sitio de Admisión de Emergencia en Fort Bliss Obstaculizaron la Gestión de Casos Para Niños
- 11-07-2022
- Three Tribes in New England and Their Health Programs Did Not Conduct Required Background Investigations on All Individuals in Contact With Indian Children A-01-20-01504
- 11-04-2022
- Updated: Corporate Integrity Agreements
- 11-03-2022
- During the Initial COVID-19 Response, HHS Personnel Who Interacted With Potentially Infected Passengers Had Limited Protections OEI-04-20-00360
October
- 10-28-2022
- Mississippi Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-21-06101
- 10-27-2022
- CMS Can Use OIG Audit Reports To Improve Its Oversight of Hospital Compliance A-04-21-08084
- California Made Almost $16 Million in Unallowable Capitation Payments for Beneficiaries With Multiple Client Index Numbers A-04-21-07097
- 10-26-2022
- Colorado Did Not Report and Refund the Correct Federal Share of Medicaid-Related Overpayments for 70 Percent of the State's Medicaid Fraud Control Unit Cases A-07-21-02834
- CMS Generally Ensured That Medicare Part C and Part D Sponsors Did Not Pay Ineligible Providers for Services to Medicare Beneficiaries A-02-20-01027
- 10-25-2022
- Payments Made to Providers Under the COVID-19 Accelerated and Advance Payments Program Were Generally in Compliance with the CARES Act and Other Federal Requirements A-05-20-00053
- 10-21-2022
- Updated: Corporate Integrity Agreements
- 10-18-2022
- IHS Did Not Always Provide the Necessary Resources and Assistance To Help Ensure That Tribal Programs Complied With All Requirements During Early COVID-19 Vaccination Program Administration A-07-21-04125
- Home Health Agencies Used Multiple Strategies To Respond to the COVID-19 Pandemic, Although Some Challenges Persist OEI-01-21-00110
- Updated: Fraud Self-Disclosures
- Updated: CMP and Affirmative Exclusions
- 10-17-2022
- Updated: Work Plan
- U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement
- 10-13-2022
- Ciertos beneficiarios de Medicare, como los beneficiarios urbanos e hispanos, fueron más propensos que otros a usar los servicios de telesalud durante el primer año de la pandemia de COVID-19 OEI-02-20-00522
- 10-12-2022
- Updated: Fraud Risk Indicator
- 10-07-2022
- LEIE Database Updated with September 2022 Exclusions and Reinstatements
- Texas Claimed or May Have Claimed More Than $30 Million of $9.89 Billion in Federal Funds for Medicaid Uncompensated Care Payments That Did Not Meet Federal and State Requirements
- 10-05-2022
- Advisory Opinion 22-19 (Regarding a proposal whereby certain pharmaceutical manufacturers would: (i) fund, through Requestor, cost-sharing subsidies for the manufacturers' Part D oncology drugs; (ii) fund, through Requestor, specified programs and eligible beneficiaries' health insurance premiums; and (iii) finance Requestor's operating costs.)
- Updated: Corporate Integrity Agreements
- 10-04-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HumanaChoice (Contract R5826) Submitted to CMS A-05-19-00039
- 10-03-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Highmark Senior Health Company (Contract H3916) Submitted to CMS A-03-19-00001
- CDC's Corrective Actions Improved Program Operations at the National Institute of Health in Mozambique and Facilitated the Institute's Implementation of Prior OIG Audit Recommendations A-04-20-01019
- UPICs Hold Promise To Enhance Program Integrity Across Medicare and Medicaid, But Challenges Remain OEI-03-20-00330
September
- 09-30-2022
- Indiana Did Not Comply With Requirements for Documenting Psychotropic and Opioid Medications Prescribed for Children in Foster Care A-05-21-00020
- Initial Observations of IHS Capacity to Manage Supplemental $3.5 Billion Appropriated to Sanitation Facilities Construction Projects OEI-06-22-00320
- Medicare Advantage Compliance Audit of Diagnosis Codes That Inter Valley Health Plan, Inc. (Contract H0545), Submitted to CMS A-05-18-00020
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That BlueCross BlueShield of Tennessee, Inc. (Contract H7917) Submitted to CMS A-07-19-01195
- Medicare Dialysis Services Provider Compliance Audit - Dialysis Clinic, Inc. A-05-20-00010
- 09-29-2022
- Delays in Confirmatory Trials for Drug Applications Granted FDA's Accelerated Approval Raise Concerns OEI-01-21-00401
- HHS's and HRSA's Controls Related to Selected Provider Relief Fund Program Requirements Could Be Improved A-09-21-06001
- Michigan Medicaid Fraud Control Unit: 2021 Review OEI-06-21-00270
- 09-28-2022
- ACF Should Improve Oversight of Head Start To Better Protect Children's Safety OEI-BL-19-00560
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2020 Average Sales Prices OEI-03-22-00170
- HHS Made Some Progress Toward Compliance With the Geospatial Data Act A-18-22-11400
- Employee Profile: Omar Pérez Aybar
- 09-27-2022
- Operational Challenges Within ORR and the ORR Emergency Intake Site at Fort Bliss Hindered Case Management for Children OEI-07-21-00251
- Medicare Hospice Provider Compliance Audit: Hospice of Palm Beach County, Inc. A-02-20-01001
- 09-23-2022
- NEW: Advisory Opinion Request Template
- End-Stage Renal Disease Network Organizations' Reported Actions Taken in Response to the COVID-19 Pandemic A-05-20-00051
- CMS's System Edits Significantly Reduced Improper Payments to Acute-Care Hospitals After May 2019 for Outpatient Services Provided to Beneficiaries Who Were Inpatients of Other Facilities A-09-22-03007
- 09-22-2022
- CMS Has Opportunities To Strengthen States' Oversight of Medicaid Managed Care Plans' Reporting of Medical Loss Ratios OEI-03-20-00231
- National Institutes of Health Grant Program Cybersecurity Requirements Need Improvement A-18-20-06300
- New York Generally Determined Eligibility for Its Basic Health Program Enrollees in Accordance With Program Requirements A-02-20-01028
- Updated: Corporate Integrity Agreements
- 09-21-2022
- FDA Repeatedly Adapted Emergency Use Authorization Policies To Address the Need for COVID-19 Testing OEI-01-20-00380
- FDA's Work with the Tri-Agency Task Force for Emergency Diagnostics Helped Labs Implement COVID-19 Tests OEI-01-20-00381
- Nearly All States Made Capitation Payments for Beneficiaries Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Two States A-05-20-00025
- 09-20-2022
- Medicare Part B Overpaid and Beneficiaries Incurred Cost-Share Overcharges of Over $1 Million for the Same Professional Services A-06-21-05003
- IHS's National Supply Service Center Was Generally Effective in Providing Supplies to Facilities During the COVID-19 Pandemic, but Its Internal Controls Could Be Improved A-07-20-04124
- Advisory Opinion 22-18 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)
- 09-19-2022
- Certain Life Care Nursing Homes May Not Have Complied With Federal Requirements for Infection Prevention and Control and Emergency Preparedness A-01-20-00004
- 09-15-2022
- Opioid Overdoses and the Limited Treatment of Opioid Use Disorder Continue To Be Concerns for Medicare Beneficiaries OEI-02-22-00390
- Tennessee Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-21-06096
- Updated: Work Plan
- 09-13-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Regence BlueCross BlueShield of Oregon (Contract H3817) Submitted to CMS A-09-20-03009
- New York Claimed $196 Million, Over 72 Percent of the Audited Amount, in Federal Reimbursement for NEMT Payments to New York City Transportation Providers That Did Not Meet or May Not Have Met Medicaid Requirements A-02-21-01001
- 09-09-2022
- The IHS Telehealth System Was Deployed Without Some Required Cybersecurity Controls A-18-21-03100
- Updated: Fraud Self-Disclosures
- 09-08-2022
- LEIE Database Updated with August 2022 Exclusions and Reinstatements
- Updated: Corporate Integrity Agreements
- 09-07-2022
- Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks OEI-02-20-00720
- Certain Medicare Beneficiaries, Such as Urban and Hispanic Beneficiaries, Were More Likely Than Others To Use Telehealth During the First Year of the COVID-19 Pandemic OEI-02-20-00522
- Connecticut Medicaid Fraud Control Unit: 2021 Inspection OEI-06-21-00360
- 09-06-2022
- Reducing Medicare's Payment Rates for Intermittent Urinary Catheters Can Save the Program and Beneficiaries Millions of Dollars Each Year OEI-04-20-00620
- Updated: Corporate Integrity Agreements
- 2023 Spring OIG Health Care Fraud and Abuse Legal Internship
- 09-02-2022
- Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria Fiscal Year 2023 Inspectors General Coordinated PEPFAR Oversight Plan U.S. Department of Health and Human Services, Office of Inspector General A-04-22-01024
- HHS Did Not Fully Comply With Federal Requirements and HHS Policies and Procedures When Awarding and Monitoring Contracts for Ventilators A-02-20-02002
- 09-01-2022
- The Municipality of Barceloneta Did Not Always Manage Its Head Start Disaster Assistance Awards in Accordance With Federal and Commonwealth Requirements A-02-20-02003
August
- 08-31-2022
- The Health Resources and Services Administration Should Improve Its Oversight of the Cybersecurity of the Organ Procurement and Transplantation Network A-18-21-11400
- 08-30-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That WellCare of Florida, Inc., (Contract H1032) Submitted to CMS A-04-19-07084
- Montana Claimed Federal Medicaid Reimbursement for More Than $5 Million in Targeted Case Management Services That Did Not Comply With Federal and State Requirements A-07-21-03246
- Updated: Corporate Integrity Agreements
- 08-29-2022
- Updated: Corporate Integrity Agreements
- 08-25-2022
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2022 OEI-03-22-00210
- 08-24-2022
- Nevada's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 9 of 30 Providers Reviewed A-09-21-01000
- 08-23-2022
- Medicare Advantage Compliance Audit of Diagnosis Codes That Cigna HealthSpring of Florida, Inc. (Contract H5410) Submitted to CMS A-03-18-00002
- 08-22-2022
- Updated List: High Risk - Heightened Scrutiny
- 08-19-2022
- Advisory Opinion 22-16 ( Regarding the provision of a gift card to certain Medicare Advantage plan enrollees who complete specific steps in an online patient education program.)
- 08-17-2022
- Updated: Work Plan
- 08-16-2022
- Las imprecisiones en los datos de raza y origen étnico de Medicare dificultan la evaluación de disparidades en la salud OEI-02-21-00100
- The National Institutes of Health Did Not Ensure That All Clinical Trial Results Were Reported in Accordance With Federal Requirements A-06-21-07000
- 08-12-2022
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2021 in Accordance With Federal Requirements A-04-22-04088
- 08-11-2022
- Part D Plan Preference for Higher-Cost Hepatitis C Drugs Led to Higher Medicare and Beneficiary Spending OEI-BL-21-00200
- South Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-21-07003
- Updated: Corporate Integrity Agreements
- 08-05-2022
- Updated:
- Updated: Corporate Integrity Agreements
- 08-03-2022
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2021 A-18-22-11300
- 08-02-2022
- Updated: Fraud Risk Indicator
- 08-01-2022
- Statement on the Passing of Former Inspector General June Gibbs Brown
- LEIE Database Updated with July 2022 Exclusions and Reinstatements
- 07-29-2022
- Certain Nursing Homes May Not Have Complied With Federal Requirements for Infection Prevention and Control and Emergency Preparedness A-01-20-00005
- 07-28-2022
- Employee Profile: Eyana J. Esters
- CMS Reported Collecting Just Over Half of the $498 Million in Medicare Overpayments Identified by OIG Audits A-04-18-03085
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- 07-21-2022
- Medicare Critical Care Services Provider Compliance Audit: Lahey Clinic, Inc. A-03-20-00002
- 07-20-2022
- Special Fraud Alert: OIG Alerts Practitioners To Exercise Caution When Entering Into Arrangements With Purported Telemedicine Companies
- 2022 National Health Care Fraud Enforcement Action
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cariten Health Plan, Inc., (Contract H4461) Submitted to CMS A-02-20-01009
- 07-19-2022
- Updated: Corporate Integrity Agreements
- 07-18-2022
- Updated: Work Plan
- Audits of Nursing Home Life Safety and Emergency Preparedness in Eight States Identified Noncompliance With Federal Requirements and Opportunities for the Centers for Medicare & Medicaid Services to Improve Resident, Visitor, and Staff Safety A-02-21-01010
- Job Openings: Office of Counsel Attorney Positions
- 07-15-2022
- CDC Found Ways To Use Data To Understand and Address COVID-19 Health Disparities, Despite Challenges With Existing Data OEI-05-20-00540
- Medicare Hospice Provider Compliance Audit: Vitas Healthcare Corporation of Florida A-02-19-01018
- 07-14-2022
- Updated: Fraud Self-Disclosures
- 07-08-2022
- LEIE Database Updated with June 2022 Exclusions and Reinstatements
- Updated: Corporate Integrity Agreements
- 07-07-2022
- In Five States, There Was No Evidence That Many Children in Foster Care Had a Screening for Sex Trafficking When They Returned After Going Missing OEI-07-19-00371
- 07-06-2022
- The Reduced Outlier Threshold Applied to Transfer Claims Did Not Significantly Increase Medicare Payments to Hospitals A-05-19-00019
- 07-05-2022
- 2021 Health Care Fraud and Abuse Control Program Report
- Advisory Opinion 22-15 (Regarding a proposal to use donations to cover: (i) specialized care furnished to veterans who meet certain criteria; and (ii) certain out-of-pocket expenses related to that specialized care. )
- 07-01-2022
- The Centers for Medicare & Medicaid Services Had Policies and Procedures in Place To Mitigate Vulnerabilities in a Timely Manner, but Improvements Are Needed A-18-20-06500
- Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2022 OEI-05-22-00230
- 06-29-2022
- The Food and Drug Administration's Foreign For-Cause Drug Inspection Program Can Be Improved To Protect the Nation's Drug Supply A-01-19-01500
- Advisory Opinion 22-14 (regarding an ophthalmology practice's proposed continuing education programs for local optometrists and four financing options to fund the programs.)
- Justice Department's Criminal Division Creates New England Prescription Opioid Strike Force to Focus on Illegal Opioid Prescriptions
- 06-28-2022
- Testimony of Erin Bliss, Assistant Inspector General, Office of Evaluation and Inspections, Office of Inspector General, United States House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, Testimony to Protecting America's Seniors: Oversight of Private Sector Medicare Advantage Plans
- More Than 90 Percent of the New Hampshire Managed Care Organization and Fee-for-Service Claims for Opioid Treatment Program Services Did Not Comply With Medicaid Requirements A-01-20-00006
- 06-27-2022
- An Estimated 91 Percent of Nursing Home Staff Nationwide Received the Required COVID-19 Vaccine Doses, and an Estimated 56 Percent of Staff Nationwide Received a Booster Dose A-09-22-02003
- 06-23-2022
- Office of Refugee Resettlement's Influx Care Facility and Emergency Intake Sites Did Not Adequately Safeguard Unaccompanied Children From COVID-19 A-06-21-07002
- Advisory Opinion 22-13 (regarding a durable medical equipment manufacturer's arrangements with two financial institutions to make zero-interest financing available to qualified customers.)
- 06-22-2022
- Updated: Corporate Integrity Agreements
- 06-21-2022
- Iowa Medicaid Fraud Control Unit: 2021 Inspection OEI-07-21-00340
- Updated: Corporate Integrity Agreements
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- 06-16-2022
- STAT Op-Ed by Christi A. Grimm, Ruth Ann Dorrill, & Julie K. Taitsman: New report: gains in patient safety have stalled over the past decade
- 06-15-2022
- Inaccuracies in Medicare's Race and Ethnicity Data Hinder the Ability To Assess Health Disparities OEI-02-21-00100
- Eye on Oversight Video: Inaccuracies in Medicare's Race and Ethnicity Data
- Updated: Work Plan
- 06-14-2022
- 2021 Performance Data for the Senior Medicare Patrol Projects OEI-02-22-00310
- 06-13-2022
- Medicare and Beneficiaries Paid Substantially More to Provider-Based Facilities in Eight Selected States in Calendar Years 2010 Through 2017 Than They Paid to Freestanding Facilities in the Same States for the Same Type of Services A-07-18-02815
- Updated: Corporate Integrity Agreements
- 06-10-2022
- LEIE Database Updated with May 2022 Exclusions and Reinstatements
- 06-08-2022
- Updated: Fraud Self-Disclosures
- 06-07-2022
- Opportunities Exist To Strengthen NIH Grantees' Oversight of Investigators' Foreign Significant Financial Interests and Other Support OEI-03-20-00210
- Maine Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents A-01-20-00007
- 06-06-2022
- Spring 2022 Semiannual Report to Congress
- California Collected and Disbursed Stimulus Payments and Income Tax Refunds Under the Federal Tax Refund Offset Program in Accordance With Federal and State Requirements A-01-21-01501
- 06-03-2022
- Texas Did Not Report and Return All Medicaid Overpayments for the State's Medicaid Fraud Control Unit's Cases A-06-20-04004
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Peoples Health Network (Contract H1961) Submitted to CMS A-06-18-05002
- 06-02-2022
- Updated Work Plan: Food and Drug Administration's Actions Regarding the Abbott Infant Formula Recall
- Cost Allocation Services Needs To Update Its Indirect Cost Rate-Setting Guidance 06-01-2022
- Vanderbilt University Medical Center: Audit of Outpatient Outlier Payments A-06-20-04003
- 06-01-2022
- Medicare Improperly Paid Durable Medical Equipment Suppliers an Estimated $8 Million of the $40 Million Paid for Power Mobility Device Repairs A-09-20-03016
- Advisory Opinion 22-12 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay. )
- Modification of Advisory Opinion 20-02 (Requestor now seeks to modify 20-02 to include Requestor's provision of financial assistance to eligible patients for travel, lodging, and certain other associated expenses in connection with a round trip to an approved treatment center for a cell-removal process associated with manufacturing Requestor's drug.)
- 05-27-2022
- Updated: Corporate Integrity Agreements
- 05-26-2022
- Selected Dialysis Companies Implemented Additional Infection Control Policies and Procedures To Protect Beneficiaries and Employees During the COVID-19 Pandemic A-05-20-00052
- 05-25-2022
- Advisory Opinion 22-11 (Regarding its proposal to employ an individual who is excluded from participation in Federal health care programs to perform marketing tasks relating to workers' compensation programs.)
- 05-23-2022
- Press Release: HHS-OIG Issues Notice of Exclusion to Owner of 7 Louisiana Nursing Homes
- National Snapshot of State Agency Approaches To Reporting and Locating Children Missing From Foster Care A-07-20-06095
- 05-19-2022
- Employee Profile: Jessica Yun Kim
- 05-17-2022
- New AI/AN Training: Improving Health and Well-Being in American Indian and Alaska Native Communities Through Compliance
- Washington State Did Not Comply With Federal and State Requirements for Claiming Enhanced Federal Reimbursement for Medicaid Managed-Care Health Home Service Expenditures A-09-20-02008
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2021 OEI-03-22-00200
- 05-16-2022
- Updated: Work Plan
- 05-12-2022
- Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm in October 2018 OEI-06-18-00400
- National Background Check Program for Long-Term-Care Providers: An Interim Assessment OEI-07-20-00181
- 05-11-2022
- Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for the Fiscal Year 2021 A-17-22-52000
- 05-10-2022
- LEIE Database Updated with April 2022 Exclusions and Reinstatements
- 05-06-2022
- 2022 Fall OIG Health Care Fraud and Abuse Legal Internship
- 05-05-2022
- Employee Profile: Jim Korn
- Updated: Corporate Integrity Agreements
- Updated: Fraud Self-Disclosures
- 05-04-2022
- 2022 Opioid Enforcement Action
- HHS Should Improve Internal Coordination Regarding Unaccompanied Children OEI-BL-20-00670
- 05-03-2022
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- 05-02-2022
- Advisory Opinion 22-10 - Modification of Advisory Opinion 15-14 (Regarding (i) a modification to OIG Advisory Opinion 15-14, issued to the requestor on November 13, 2015, to include within the scope of that opinion, the requestor's proposal to provide financial assistance for certain past magnetic resonance imaging tests; and (ii) a second arrangement regarding the distribution of certain cooling and mobility items, ancillary to the arrangement addressed in OIG Advisory Opinion 15-14.)
- 04-28-2022
- Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care OEI-09-18-00260
- Eye on Oversight Video: Medicare Advantage Denials of Care
- National Snapshot of Trends in the National Domestic Violence Hotline's Contact Data Before and During the COVID-19 Pandemic A-09-21-06000
- Advisory Opinion 22-09 (Regarding a proposed arrangement pursuant to which Requestor would compensate hospitals for certain specimen collection services for laboratory tests furnished by Requestor.)
- 04-27-2022
- Advisory Opinion 22-08 (Regarding an arrangement whereby certain existing patients of Requestor use limited-use smartphones that Requestor loaned to such patients to facilitate access to telehealth services.)
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2021 A-18-21-11200
- 04-26-2022
- Massachusetts Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents A-01-20-00003
- 04-25-2022
- Advisory Opinion 22-07 (Regarding an arrangement whereby certain physicians have an ownership interest in a medical device company that manufactures products that may be ordered by the physician owners and a physician spouse of one of the physician owners.)
- 04-22-2022
- California Improperly Claimed at Least $23 Million of $260 Million in Total Medicaid Reimbursement for Opioid Treatment Program Services A-09-20-02009
- 04-21-2022
- Updated: Fraud Risk Indicator
- 04-20-2022
- 2022 National COVID-19 Health Care Fraud Enforcement Action
- 04-18-2022
- Updated: Corporate Integrity Agreements
- 04-15-2022
- Updated: Work Plan
- 04-14-2022
- Updated: Corporate Integrity Agreements
- 04-11-2022
- Louisiana Faced Compliance and Contracting Challenges in Implementing Opioid Response Grant Programs A-06-20-07003
- Advisory Opinion 22-06 Regarding the provision of free genetic testing and genetic counseling services to individuals who meet specified clinical criteria.
- Updated: Corporate Integrity Agreements
- 04-08-2022
- LEIE Database Updated with March 2022 Exclusions and Reinstatements
- Posthospital Skilled Nursing Facility Care Provided to Dually Eligible Beneficiaries in Indiana Generally Met Medicare Level-of-Care Requirements A-05-20-00005
- 04-07-2022
- New COVID-19 Enforcement Action
- Updated: CIA Reportable Events, CMP and Affirmative Exclusions, and Fraud Self-Disclosures
- 04-06-2022
- Updated: Corporate Integrity Agreements
- 04-05-2022
- Featured Topic: Telehealth
- 04-04-2022
- South Carolina Did Not Fully Comply With Requirements for Reporting and Monitoring Critical Events Involving Medicaid Beneficiaries With Developmental Disabilities A-04-18-07078
- 03-31-2022
- Medicare Part D and Beneficiaries Could Realize Significant Spending Reductions With Increased Biosimilar Use OEI-05-20-00480
- 03-30-2022
- Inspector General Grimm HCCA 26th Annual Compliance Institute Keynote
- Psychotherapy Services Billed by a New York City Provider Did Not Comply With Medicare Requirements A-02-21-01006
- 03-28-2022
- FY 2023 Congressional Budget Justification
- Employee Profile: Rosemary Bartholomew
- 03-22-2022
- New Mexico Did Not Claim $12.4 Million of $222.6 Million in Medicaid Payments for Services Provided by Indian Health Service Facilities in Accordance With Federal and State Requirements A-06-19-09005
- 03-17-2022
- Telehealth Was Critical for Providing Services to Medicare Beneficiaries During the First Year of the COVID-19 Pandemic OEI-02-20-00520
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- New COVID-19 Enforcement Action
- 03-16-2022
- Advisory Opinion 22-05 Regarding the proposed subsidization of certain Medicare cost-sharing obligations in the context of a clinical trial.
- New York Verified That Medicaid Assisted Living Program Providers Met Life Safety and Emergency Planning Requirements But Did Not Always Ensure That Assisted Living Program Services Met Federal and State Requirements A-02-19-01017
- 03-15-2022
- Updated: Work Plan
- Medicaid Fraud Control Units Fiscal Year 2021 Annual Report OEI-09-22-00020
- 03-10-2022
- New Video: Our Impact: HHS-OIG
- LEIE Database Updated with February 2022 Exclusions and Reinstatements
- New Jersey's Medicaid School-Based Cost Settlement Process Could Result in Claims That Do Not Meet Federal Requirements A-02-20-01012
- 03-08-2022
- Updated: Corporate Integrity Agreements
- Updated: Fraud Self-Disclosures
- 03-04-2022
- The Centers for Medicare & Medicaid Services' Eligibility Review Contractor Adequately Determined Medicaid Eligibility for Selected States Under the Payment Error Rate Measurement Program A-02-20-01006
- New COVID-19 Enforcement Action
- 03-03-2022
- Updated: Corporate Integrity Agreements
- 03-02-2022
- Leadership Update
- Advisory Opinion 22-04 (Regarding a program through which Requestor provides certain individuals access to digital contingency management and related tools to treat substance use disorders, where the Program is funded by customers, which could include individuals' health care providers or suppliers.)
- 03-01-2022
- Texas Did Not Ensure Documentation Supported That Individuals Met Eligibility Requirements and That Its Annual Report Was Accurate Under Its Projects for Assistance in Transition From Homelessness Program A-02-21-02001
- 02-23-2022
- Employee Profile: Angela Grimes
- Hospitals Did Not Always Meet Differing Medicare Contractor Specifications for Bariatric Surgery A-09-20-03007
- Office of Inspector General's Partnership With the Oregon Secretary of State's Audits Division: Oregon Health Authority-Timely Notification of Inpatient Hospital Stays Could Help Reduce Improper Medicaid Payments A-09-22-02001
- 02-18-2022
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2021 OEI-03-22-00190
- Updated: Corporate Integrity Agreements
- 02-17-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Tufts Health Plan (Contract H2256) Submitted to CMS A-01-19-00500
- 02-16-2022
- Medicare Payments of $6.6 Billion to Nonhospice Providers Over 10 Years for Items and Services Provided to Hospice Beneficiaries Suggest the Need for Increased Oversight A-09-20-03015
- Updated: Work Plan
- 02-14-2022
- Office of Refugee Resettlement Generally Ensured That Selected Care Provider Facilities for Its Unaccompanied Children Program Complied With Federal Emergency Preparedness Requirements A-04-20-02025
- Advisory Opinion 22-03 (Regarding Requestors' proposal to pay salaries to, and nurse aide certification program tuition costs on behalf of, new employees who Requestors have hired to work as certified nurse aides for Requestors' home health agencies.)
- 02-10-2022
- LEIE Database Updated with January 2022 Exclusions and Reinstatements
- Updated: Health Care Fraud Self-Disclosures
- 02-09-2022
- Advisory Opinion 22-02 (Regarding a proposed arrangement between Requestor and two individuals, pursuant to which Requestor and the individuals would reduce and subsidize certain costs incurred by qualifying patients of Requestor's children's hospital.)
- The National Institutes of Health Could Improve Its Post-Award Process for the Oversight and Monitoring of Grant Awards A-03-20-03001
- 02-08-2022
- Findings of Whistleblower Retaliation by CDC Central America Regional HIV Program Management Official
- 02-07-2022
- Updated: Corporate Integrity Agreements
- 02-04-2022
- Medicare Advantage Compliance Audit of Diagnosis Codes That SCAN Health Plan (Contract H5425) Submitted to CMS A-07-17-01169
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- 02-03-2022
- Prior Audits of Medicaid Eligibility Determinations in Four States Identified Millions of Beneficiaries Who Did Not or May Not Have Met Eligibility Requirements A-02-20-01018
- 02-02-2022
- Updated: Corporate Integrity Agreements
- Updated: Fraud Risk Indicator
- 02-01-2022
- Independent Attestation Report: Food and Drug Administration Budget Formulation Compliance Report and Detailed Accounting Submission for Fiscal Year 2021 National Drug Control Activities, and Accompanying Required Assertions A-03-22-00352
- 01-27-2022
- The Assistant Secretary for Administration Awarded and Managed Five Sole Source Contracts for COVID-19 Testing in Accordance With Federal and Contract Requirements A-05-21-00014
- HHS's Suspension and Debarment Program Helped Safeguard Federal Funding, But Opportunities for Improvement Exist OEI-04-19-00570
- 01-26-2022
- Independent Attestation Review: Centers for Medicare & Medicaid Services Fiscal Year 2021 Detailed Accounting Submission and Budget Formulation Compliance Report for National Drug Control Activities, and Accompanying Required Assertions A-03-22-00351
- 01-24-2022
- New COVID-19 Enforcement Action
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- 01-19-2022
- Advisory Opinion 22-01 (Regarding the proposed expansion of discount programs for low-income individuals.)
- 01-18-2022
- CMS Should Take Further Action To Address States With Poor Performance in Conducting Nursing Home Surveys OEI-06-19-00460
- Updated: Corporate Integrity Agreements
- Updated: Work Plan
- 01-14-2022
- Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings A-04-21-06254
- New COVID-19 Enforcement Action
- 01-13-2022
- Updated: Corporate Integrity Agreements
- 01-12-2022
- Updated: Health Care Fraud Self-Disclosures
- 01-11-2022
- Updated: CMP and Affirmative Exclusions and CIA Reportable Events
- 01-10-2022
- LEIE Database Updated with December 2021 Exclusions and Reinstatements
- Updated: Corporate Integrity Agreements
- 01-07-2022
- Job Openings: Office of Counsel Attorney Positions
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Healthfirst Health Plan, Inc., (Contract H3359) Submitted to CMS A-02-18-01029
- 01-06-2022
- Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Assets as of December 31, 2016 A-07-21-00603
- Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2014 Through 2016 A-07-21-00602
- Updated: Corporate Integrity Agreements
- 01-05-2022
- Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals for Calendar Years 2014 Through 2016 A-07-21-00605
- Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Postretirement Benefit Assets as of January 1, 2017 A-07-21-00604
- 01-04-2022
- COVID-19 Tests Drove an Increase in Total Medicare Part B Spending on Lab Tests in 2020, While Use of Non-COVID-19 Tests Decreased Significantly OEI-09-21-00240
- Louisiana's Monitoring Did Not Ensure Child Care Provider Compliance With Criminal Background Check Requirements at 8 of 30 Providers Reviewed A-06-19-02001
July
June
May
April
March
February
January
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December
- 12-30-2021
- Medicare and Beneficiaries Pay More for Preadmission Services at Affiliated Hospitals Than at Wholly Owned Settings OEI-05-19-00380
- 12-23-2021
- Arkansas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-01003
- 12-21-2021
- Trends in Genetic Tests Provided Under Medicare Part B Indicate Areas of Possible Concern A-09-20-03027
- 12-20-2021
- Medicare Hospital Provider Compliance Audit: St. Joseph's Hospital Health Center A-02-20-01004
- The Food and Drug Administration Needs To Improve Its Contract Closeout Processes To Identify Contracts Eligible for Closeout and Close Contracts Timely A-03-20-03004
- 12-17-2021
- Updated: Corporate Integrity Agreements
- 12-16-2021
- Many Medicare Beneficiaries Are Not Receiving Medication to Treat Their Opioid Use Disorder
- Advisory Opinion 21-20 (Regarding Requestor's proposal to create an online platform for: (i) users to search for and contact home-based health care providers, where providers listed on the website would be charged on a per-click basis; and (ii) advertising by individuals and entities other than home-based health care providers.)
- 12-15-2021
- Updated: Work Plan
- 12-14-2021
- Updated Corporate Integrity Agreements FAQ: Should Reportable Events also be disclosed to the OIG's Self-Disclosure Protocol?
- 12-10-2021
- Medicare Could Have Saved Approximately $993 Million in 2017 and 2018 if It Had Implemented an Inpatient Rehabilitation Facility Transfer Payment Policy for Early Discharges to Home Health Agencies A-01-20-00501
- 12-09-2021
- LEIE Database Updated with November 2021 Exclusions and Reinstatements
- Updated: Corporate Integrity Agreements
- Updated: CMP and Affirmative Exclusions and Health Care Fraud Self-Disclosures
- 12-08-2021
- Video: HHS-OIG 2021 Year in Review
- 12-07-2021
- Updated: Corporate Integrity Agreements
- 12-06-2021
- New COVID-19 Enforcement Actions
- Medicare Improperly Paid Physicians for Spinal Facet-Joint Denervation Sessions A-09-21-03002
- Advisory Opinion 21-19 (Regarding Requestor's provision of free eye drops that mitigate side effects for patients using one of its products.)
- 12-03-2021
- Kentucky Made Almost $2 Million in Unallowable Capitation Payments for Beneficiaries With Multiple Medicaid ID Numbers A-04-20-07094
- 12-02-2021
- 2021 Fall Semiannual Report to Congress
- Taxpayers Could Save Nearly $4 Billion Dollars as a Result of HHS-OIG Work in FY 2021
- Updated: Corporate Integrity Agreements
- New COVID-19 Work Plan Item
November
- 11-24-2021
- CMS Should Strengthen Its Prescription Drug Event Guidance To Clarify Reporting of Sponsor Margin for Medicare Part D Bids A-03-17-00001
- 11-23-2021
- The Office of Intergovernmental and External Affairs Needs To Improve Internal Controls Over Its Travel Card Program A-03-19-00501
- 11-22-2021
- Facility-Initiated Discharges in Nursing Homes Require Further Attention OEI-01-18-00250
- New COVID-19 Enforcement Action
- Advisory Opinion 21-18 (Regarding a proposed joint venture for the provision of therapy services.)
- 11-19-2021
- Updated: Work Plan
- Advisory Opinion 21-17 (Regarding the proposed subsidization of beneficiary cost-sharing obligations for Medicare-covered services provided as part of a clinical trial.)
- 11-18-2021
- Missouri Properly Converted Provisionally Enrolled Medicaid Providers to Permanent Providers A-07-21-03248
- Medicare Improperly Paid Suppliers an Estimated $117 Million Over 4 Years for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Hospice Beneficiaries A-09-20-03026
- 11-16-2021
- 2021 Top Management and Performance Challenges Facing HHS
- Characteristics of Separated Children in ORR's Care: June 27, 2018–November 15, 2020 OEI-BL-20-00680
- Advisory Opinion 21-16 (Regarding a pharmaceutical manufacturer's arrangement to provide up to a specified number of trial units of a long-acting antipsychotic drug to certain hospitals for inpatient use.)
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2021 OEI-03-22-00060
- 11-10-2021
- New COVID-19 Enforcement Action
- Updated: Corporate Integrity Agreements
- Advisory Opinion 21-15 (Regarding a pain management company's proposal to retain net profits from services provided by an employed certified registered nurse anesthetist pursuant to a reassignment of billing rights.)
- 11-09-2021
- LEIE Database Updated with October 2021 Exclusions and Reinstatements
- Updated: Health Care Fraud Self-Disclosures
- 11-08-2021
- Updated: Health Care Fraud Self-Disclosure Protocol
- The District of Columbia's Monitoring Did Not Ensure Child Care Provider Compliance With Criminal Background Check Requirements at 7 of 30 Providers Reviewed A-03-20-00252
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UPMC Health Plan, Inc. (Contract H3907) Submitted to CMS A-07-19-01188
- Michigan Did Not Report Calendar Year 2019 Medicaid Third-Party Liability Cost Avoidance Data to the Centers for Medicare & Medicaid Services A-05-20-00058
- 11-04-2021
- Two Critical HHS Systems Were Deployed Without Authorizations to Operate
- Updated: CMP and Affirmative Exclusions and Updated Stipulated Penalties and Exclusion for Material Breach
- New COVID-19 Enforcement Action
- 11-03-2021
- Updated: Corporate Integrity Agreements
- 11-02-2021
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health Care of Missouri, Inc. (Contract H2663) Submitted to CMS A-07-17-01173
October
- 10-28-2021
- Office of Inspector General's Partnership With the Commonwealth of Massachusetts Office of the State Auditor: Office of Medicaid (MassHealth) - Payments for Hospice-Related Services for Dual-Eligible Members A-01-20-00001
- 10-27-2021
- 2021 Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs
- 10-26-2021
- Updated: Corporate Integrity Agreements
- 10-25-2021
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2020 in Accordance With Federal Requirements A-04-21-04081
- Video: HHS-OIG is Working for You
- 10-21-2021
- Tennessee Medicaid Claimed Hundreds of Millions of Federal Funds for Certified Public Expenditures That Were Not in Compliance With Federal Requirements A-04-19-04070
- Updated: Fraud Risk Indicator
- 10-20-2021
- More Than One-Third of Medicaid-Enrolled Children in Five States Did Not Receive Required Blood Lead Screening Tests OEI-07-18-00371
- Most Medicare beneficiaries received telehealth services only from providers with whom they had an established relationship OEI-02-20-00521
- Annual Inflation Updates to the Annual Cap on Patient Engagement Tools and Supports Under 42 CFR § 1001.952(hh)
- 10-19-2021
- New COVID-19 Work Plan Item
- Updated: Work Plan
- 10-15-2021
- A Look at Drug Spending
- 10-14-2021
- Changes Made to States' Medicaid Programs To Ensure Beneficiary Access to Prescriptions During the COVID-19 Pandemic A-06-20-04007
- 10-13-2021
- U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement A-17-21-54000
- 10-08-2021
- Minnesota Medicaid Managed Care Entities Used a Majority of Medicaid Funds Received for Medical Expenses and Quality Improvement Activities A-05-18-00018
- 10-07-2021
- LEIE Database Updated with September 2021 Exclusions and Reinstatements
- Updated: Corporate Integrity Agreements
- 10-06-2021
- Updated: CMP and Affirmative Exclusions and Provider Self Disclosures
- Updated: Corporate Integrity Agreements
- 10-05-2021
- Medicare Overpaid $636 Million for Neurostimulator Implantation Surgeries A-01-18-00500
- SAMHSA's Oversight Generally Ensured That the Commission on Accreditation of Rehabilitation Facilities Verified That Opioid Treatment Programs Met Federal Opioid Treatment Standards A-09-20-01002
- Advisory Opinion 21-14 (Regarding a proposal to extend an existing discount program for chiropractic patients to include Federal health care program beneficiaries.)
- 10-04-2021
- Advisory Opinion 21-13 (Regarding the proposed subsidization of beneficiary cost-sharing obligations for Medicare-covered services provided as part of a clinical trial.)
- 10-01-2021
- Updated: Corporate Integrity Agreements
September
- 09-30-2021
- Case Study: Missouri's Efforts To Protect Children Missing From Foster Care OEI-07-19-00372
- High-expenditure Medicare drugs often qualified for Orphan Drug Act incentives designed to encourage the development of treatments for rare diseases OEI-BL-20-00080
- New COVID-19 Enforcement Action
- 09-29-2021
- New COVID-19 Enforcement Actions
- 09-27-2021
- PDIG Grimm American Health Law Association Fraud and Compliance Forum Keynote
- Six of Eight Home Health Agency Providers Had Infection Control Policies and Procedures That Complied With CMS Requirements and Followed CMS COVID-19 Guidance To Safeguard Medicare Beneficiaries, Caregivers, and Staff During the COVID-19 Pandemic A-01-20-00508
- Updated: Corporate Integrity Agreements
- 09-23-2021
- California Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-09-19-02004
- About Seventy-Nine Percent of Opioid Treatment Program Services Provided to Medicaid Beneficiaries in Colorado Did Not Meet Federal and State Requirements A-07-20-04118
- 09-22-2021
- Request for Information: Modernization Initiative To Improve HHS-OIG Public Resources
- Some Medicare Advantage Companies Leveraged Chart Reviews and Health Risk Assessments To Disproportionately Drive Payments OEI-03-17-00474
- 09-21-2021
- Opportunities Exist To Strengthen Evaluation and Oversight of Telehealth for Behavioral Health in Medicaid OEI-02-19-00401
- States Reported Multiple Challenges With Using Telehealth To Provide Behavioral Health Services to Medicaid Enrollees OEI-02-19-00400
- Indian Health Service Use of Critical Care Response Teams Has Helped To Meet Facility Needs During the COVID-19 Pandemic OEI-06-20-00700
- New Mexico Medicaid Fraud Control Unit: 2020 Review OEI-06-20-00550
- 09-17-2021
- 2021 National Health Care Fraud Enforcement Action
- Updated: Work Plan
- 09-16-2021
- HHS Needs to Improve Contingency Planning Oversight of its IT Systems A-18-20-04007
- 09-15-2021
- Advisory Opinion 21-12 (Regarding a critical access hospital's proposal to offer an arrangement similar to a warranty to patients undergoing certain joint replacement procedures at the hospital.)
- 09-14-2021
- Updated: Corporate Integrity Agreements
- 09-13-2021
- New COVID-19 Enforcement Action
- 09-10-2021
- LEIE Database Updated with August 2021 Exclusions and Reinstatements
- An Ophthalmology Clinic in Florida: Audit of Medicare Payments for Eye Injections of Avastin, Eylea, and Lucentis A-09-19-03025
- 2022 Spring OIG Health Care Fraud and Abuse Legal Internship
- 09-09-2021
- Colorado Did Not Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-17-06075
- South Carolina Medicaid Fraud Control Unit: 2020 Inspection OEI-02-20-00610
- 09-03-2021
- CMS's COVID-19 Data Included Required Information From the Vast Majority of Nursing Homes, but CMS Could Take Actions To Improve Completeness and Accuracy of the Data A-09-20-02005
- Updated: Corporate Integrity Agreements
- 09-02-2021
- Kansas Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-07-20-05125
- 09-01-2021
- Medicare Beneficiaries Hospitalized With COVID-19 Experienced a Wide Range of Serious, Complex Conditions OEI-02-20-00410
- The National Human Genome Research Institute Should Strengthen Procedures in Its Pre-Award Process To Assess Risk for Certain Foreign and Higher Risk Applicants A-05-20-00026
August
- 08-31-2021
- Updated: Corporate Integrity Agreements
- 08-27-2021
- CGS Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-21-00613
- Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria: Fiscal Year 2022 Inspectors General Coordinated PEPFAR Oversight Plan A-04-21-01023
- 08-26-2021
- CMS Needs To Issue Regulations Related to Phlebotomy Travel Allowances A-06-20-04000
- CGS Administrators, LLC, Claimed Some Unallowable Medicare Excess Plan Costs Through Its Incurred Cost Proposals A-07-21-00612
- 08-25-2021
- Job Opening: Associate Counsel for Exclusions
- 08-24-2021
- Although CDC Implemented Our Prior Audit Recommendations, Its Corrective Actions Did Not Effectively Address Findings Related to 3 of Our 13 Recommendations A-04-19-01014
- 08-23-2021
- Oklahoma's Oversight of Medicaid Outpatient Services for Opioid Use Disorder Was Generally Effective A-06-20-08000
- 08-20-2021
- Medicare Home Health Agency Provider Compliance Audit: Catholic Home Care A-02-19-01013
- 08-19-2021
- Advisory Opinion 21-11 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company contracts with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, provides a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay. )
- Medicare Hospital Provider Compliance Audit: Jewish Hospital A-04-19-08077
- CGS Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-20-00593
- CGS Administrators, LLC, Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan III Costs Through Its Incurred Cost Proposals A-07-21-00608
- Louisiana Medicaid Fraud Control Unit: 2020 Inspection OEI-12-20-00650
- 08-17-2021
- New COVID-19 Enforcement Action
- Updated: Corporate Integrity Agreements
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2021 OEI-03-21-00080
- Mississippi Medicaid Fraud Control Unit: 2020 Inspection OEI-12-20-00200
- 08-16-2021
- Updated: COVID-19 Fraud Alert Information
- Medicare Paid New Hospitals Three Times More for Their Capital Costs Than They Would Have Been Paid Under the Inpatient Prospective Payment System A-07-19-02818
- Missouri Claimed Federal Reimbursement for $3.4 Million in Payments to Health Home Providers That Did Not Meet Medicaid Requirements A-07-20-04117
- Updated: Work Plan
- 08-13-2021
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Excess Plan Costs Through Its Incurred Cost Proposals A-07-21-00616
- 08-12-2021
- Concerns Persist about Opioid Overdoses and Medicare Beneficiaries' Access to Treatment and Overdose-Reversal Drugs OEI-02-20-00401
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan III Costs Through Its Incurred Cost Proposals A-07-21-00615
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-21-00614
- Companion Data Services, LLC, Supplemental Executive Retirement Plan III Costs Claimed Through Incurred Cost Proposals Were Allowable and Reasonable A-07-21-00611
- 08-11-2021
- Companion Data Services, LLC, Claimed Some Unallowable Medicare Excess Plan Costs Through Its Incurred Cost Proposals A-07-21-00610
- Companion Data Services, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-21-00609
- Palmetto Government Benefits Administrator, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-20-00592
- 08-10-2021
- LEIE Database Updated with July 2021 Exclusions and Reinstatements
- Updated: CMP and Affirmative Exclusions and Provider Self Disclosures
- Almost All of the Medicare Pension Costs That Companion Data Services, LLC, Claimed Through Its Incurred Cost Proposals Were Allowable A-07-20-00594
- 08-09-2021
- Updated: COVID-19 Fraud Alert Information
- Medicare Continues To Make Overpayments for Chronic Care Management Services, Costing the Program and Its Beneficiaries Millions of Dollars A-07-19-05122
- 08-06-2021
- Advisory Opinion 21-10 (Regarding a dental provider's provision of free routine and emergency dental services to certain indigent residents of skilled nursing facilities and nursing facilities.)
- Nationwide, Almost All Medicaid Managed Care Plans Achieved Their Medical Loss Ratio Targets OEI-03-20-00230
- 08-04-2021
- Updated: Work Plan
- Updated: Corporate Integrity Agreements
- 08-02-2021
- Almost 15 Percent of Arkansas' Private Contractor Costs Were Either Unallowable or Claimed at Higher Federal Matching Rates Than Eligible, Resulting in Arkansas Inappropriately Claiming $4.4 Million in Federal Medicaid Funds A-06-18-09002
- Updated: Work Plan
July
- 07-29-2021
- States' Backlogs of Standard Surveys of Nursing Homes Grew Substantially During the COVID-19 Pandemic OEI-01-20-00431
- 07-23-2021
- Texas Made Unallowable Children's Health Insurance Program Payments for Beneficiaries Assigned More Than One Identification Number A-06-20-10003
- 07-22-2021
- Palmetto GBA, LLC, Accurately Calculated Hospice Cap Amounts but Did Not Collect All Cap Overpayments A-06-19-08003
- New York Improperly Claimed $439 Million In Medicaid Funds for Its School-Based Health Services Based on Certified Public Expenditures A-02-18-01019
- 07-21-2021
- Updated: COVID-19 Fraud Alert Information
- Updated: Corporate Integrity Agreements
- 07-20-2021
- Updated: Fraud Risk Indicator
- 07-19-2021
- Advisory Opinion 21-09 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)
- 07-15-2021
- New COVID-19 Enforcement Action
- Updated: Work Plan
- Updated: Corporate Integrity Agreements
- 07-14-2021
- FY 2020 Health Care Fraud and Abuse Control Program Report
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2020 A-18-21-11300
- Audit of Medicare Part D Pharmacy Fees: Group Health Cooperative, Inc. A-03-19-00002
- Medicare Hospice Provider Compliance Audit: Partners In Care, Inc. A-09-18-03024
- 07-12-2021
- Medicare Hospice Provider Compliance Audit: Mission Hospice & Home Care, Inc. A-09-18-03009
- Indiana Received Over $22 Million in Excess Federal Funds Related to Unsupported Community Integration and Habilitation Waiver Services at 12 Selected Service Providers A-05-19-00022
- Medicare Hospital Provider Compliance Audit: Lake Hospital System A-05-19-00024
- 07-09-2021
- The Centers for Medicare & Medicaid Services Did Not Account for National Security Risks in Its Enterprise Risk Management Processes A-18-20-06200
- Medicare Payments for Transitional Care Management Services Generally Complied With Federal Requirements, but Some Overpayments Were Made A-07-17-05100
- New York's Claims for Federal Reimbursement for Payments to Health Home Providers on Behalf of Beneficiaries Diagnosed With Serious Mental Illness or Substance Use Disorder Generally Met Medicaid Requirements But It Still Made $6 Million in Improper Payments to Some Providers A-02-19-01007
- LEIE Database Updated with June 2021 Exclusions and Reinstatements
- 07-08-2021
- The National Heart, Lung, and Blood Institute Did Not Fully Comply With Federal Requirements for Other Transactions A-04-20-04078
- Advisory Opinion 21-08 (Regarding financial assistance for transportation, lodging, and meals provided by a pharmaceutical manufacturer to certain patients potentially eligible for treatment with the pharmaceutical manufacturer's drug. )
- Updated: Provider Self Disclosures
- Updated: Corporate Integrity Agreements
- 07-07-2021
- The Puerto Rico Department of Health's Implementation of Its Emergency Preparedness and Response Activities Before and After Hurricane Maria Was Not Effective
- Advisory Opinion 21-07 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay. )
- 07-06-2021
- PDIG Grimm Provides Update on Oversight of COVID-19-Related Programs
June
- 06-30-2021
- 2020 Performance Data for the Senior Medicare Patrol Projects OEI-02-21-00180
- Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2021 OEI-05-21-00170
- 06-29-2021
- Advisory Opinion 21-06 (Regarding a spinal implant manufacturer�s proposal to offer its products to hospitals at a reduced price if the hospitals agree to assume certain duties related to the products.)
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- 06-28-2021
- CMS's Controls Related to Hospital Preparedness for an Emerging Infectious Disease Were Well-Designed and Implemented but Its Authority Is Not Sufficient for It To Ensure Preparedness at Accredited Hospitals A-02-21-01003
- Medicare Hospital Provider Compliance Audit: Staten Island University Hospital A-02-18-01025
- 06-25-2021
- Kentucky Claimed Millions in Unallowable School-Based Medicaid Administrative Costs A-04-17-00113
- Medicare Hospice Provider Compliance Audit: Northwest Hospice, LLC A-09-20-03035
- 06-23-2021
- Medicare Lacks Consistent Oversight of Cybersecurity for Networked Medical Devices in Hospitals OEI-01-20-00220
- 06-22-2021
- COVID-19 Had a Devastating Impact on Medicare Beneficiaries in Nursing Homes During 2020 OEI-02-20-00490
- New Featured Topic: Nursing Homes
- 06-16-2021
- SAMHSA Is Missing Opportunities To Better Monitor Access to Medication Assisted Treatment Through the Buprenorphine Waiver Program OEI-BL-20-00260
- 06-15-2021
- Updated: Work Plan
- Selected NIH Institutes Met Requirements for Documenting Peer Review But Could Do More To Track and Explain Funding Decisions OEI-01-19-00140
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2019 Average Sales Prices OEI-03-21-00130
- 06-14-2021
- California Did Not Ensure That Nursing Facilities Always Reported Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Properly A-09-19-02005
- Nebraska Did Not Report and Refund the Correct Federal Share of Medicaid-Related Overpayments for 76 Percent of the State's Medicaid Fraud Control Unit Cases A-07-18-02814
- 06-11-2021
- Medicare Hospice Provider Compliance Audit: Professional Healthcare at Home, LLC A-09-18-03028
- 06-09-2021
- Opportunities Exist for CMS and Its Medicare Contractors To Strengthen Program Safeguards To Prevent and Detect Improper Payments for Drug Testing Services A-09-20-03017
- Updated: Provider Self Disclosures
- 06-08-2021
- LEIE Database Updated with May 2021 Exclusions and Reinstatements
- 06-04-2021
- University of Michigan Health System: Audit of Medicare Payments for Polysomnography Services A-04-20-07088
- Updated: Corporate Integrity Agreements
- 06-03-2021
- New Mexico Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-06-16-00001
- New COVID-19 Enforcement Action
- Updated: Work Plan
- 06-01-2021
- Medicare Home Health Agency Provider Compliance Audit: Caretenders of Jacksonville, LLC A-04-16-06195
- Gateway Community Action Partnership Claimed Unallowable Costs, Did Not Comply With Federal Regulations on Construction and Major Renovations, and Did Not Accurately Account for Grant Funds A-02-18-02011
May
- 05-28-2021
- FY 2022 Congressional Budget Justification
- Spring 2021 Semiannual Report to Congress
- Updated: Corporate Integrity Agreements
- 05-27-2021
- Toolkit: Insights from OIG's Work on the Office of Refugee Resettlement's Efforts To Care for Unaccompanied Children OEI-09-21-00220
- Blue Cross Blue Shield of South Carolina Overstated Its Excess Plan Partial Medicare Segment Pension Assets as of January 1, 2017 A-07-21-00607
- Medicare Made Millions of Dollars in Overpayments for End-Stage Renal Disease Monthly Capitation Payments A-07-19-05117
- Updated: Corporate Integrity Agreements
- 05-26-2021
- 2021 National COVID-19 Health Care Fraud Takedown
- 05-24-2021
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Anthem Community Insurance Company, Inc. (Contract H3655) Submitted to CMS A-07-19-01187
- Updated COVID-19 FAQs
- 05-21-2021
- Sleep Management, LLC: Audit of Claims for Monthly Rental of Noninvasive Home Ventilators A-04-18-04066
- 05-20-2021
- Medicare Hospice Provider Compliance Audit: Franciscan Hospice A-09-20-03034
- Updated: Corporate Integrity Agreements
- Advisory Opinion 21-05 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)
- 05-19-2021
- New York Did Not Have Adequate Oversight of Its Reported Temporary Assistance for Needy Families Program Expenditures A-02-17-02005
- Advisory Opinion 21-04 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)
- 05-18-2021
- Medicare Hospice Provider Compliance Audit: Alive Hospice, Inc. A-09-18-03016
- Medicare Hospice Provider Compliance Audit: Ambercare Hospice, Inc. A-09-18-03017
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2020 OEI-03-21-00070
- New COVID-19 Enforcement Action
- 05-17-2021
- NEW: Behavioral Health-Medication-Assisted Treatment Viewer
- Updated: Work Plan
- U.S. Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for Fiscal Year 2020 A-17-21-52000
- CMS Needs to Strengthen Regulatory Requirements for Medicare Part B Outpatient Cardiac and Pulmonary Rehabilitation Services to Ensure Providers Fully Meet Coverage Requirements A-02-18-01026
- Advisory Opinion 21-03 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)
- 05-14-2021
- Minnesota Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00032
- 05-13-2021
- New York Made Unallowable Payments Totaling More Than $9 Million to the Same Managed Care Organization for Beneficiaries Assigned More Than One Medicaid Identification Number A-02-20-01007
- 05-12-2021
- Medicare Could Have Saved up to $20 Million Over 5 Years if CMS Oversight Had Been Adequate To Prevent Payments for Medically Unnecessary Cholesterol Blood Tests A-09-19-03027
- 05-11-2021
- Risk Assessment of the Food and Drug Administration's Travel Card Program A-04-19-06235
- Updated: Corporate Integrity Agreements
- New COVID-19 Enforcement Action
- 05-10-2021
- Medicare Hospice Provider Compliance Audit: Suncoast Hospice A-02-18-01001
- 05-07-2021
- Louisiana Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-02005
- The Substance Abuse and Mental Health Services Administration Generally Had Controls and Strategies for Mitigating Disaster Preparedness and Response Risks A-04-20-02026
- Updated: Corporate Integrity Agreements
- 05-06-2021
- CMS Could Improve the Data It Uses To Monitor Antipsychotic Drugs in Nursing Homes OEI-07-19-00490
- Updated: CIA Reportable Events and Provider Self Disclosures
- 05-05-2021
- Updated COVID-19 FAQs
- Medicare Hospital Provider Compliance Audit: Virtua Our Lady of Lourdes Hospital A-02-18-01018
- Updated: Corporate Integrity Agreements
- 05-03-2021
- LEIE Database Updated with April 2021 Exclusions and Reinstatements
April
- 04-29-2021
- New Video: HHS-OIG Update on Compliance
- Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Maryland A-03-17-00009
- Advisory Opinion 21-02 (regarding an investment by a health system, certain surgeons, and a management company in an ambulatory surgery center.)
- 04-27-2021
- Louisiana Appropriately Claimed Most Balancing Incentive Payment Program Funds A-06-19-02000
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- 04-26-2021
- Updated: Corporate Integrity Agreements
- 04-23-2021
- Office of Inspector General's Partnership with the Office of the New York State Comptroller: Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare A-02-21-01008
- New Whistleblower Protection Information Brochure
- 04-22-2021
- HHS-OIG Update on Compliance: Principal Deputy Inspector General Christi A. Grimm speaks at the HCCA 25th Annual Compliance Institute
- Testimony of Gary L. Cantrell, Deputy Inspector General, Office of Investigations, Office of Inspector General, U.S. House Committee on Health, Education, Labor and Pensions: Protecting U.S. Biomedical Research: Efforts to Prevent Undue Foreign Influence
- 04-21-2021
- Colorado's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 18 of 30 Providers Reviewed A-07-19-06084
- 04-20-2021
- Medicare Advantage Compliance Audit of Diagnosis Codes That Humana, Inc., (Contract H1036) Submitted to CMS A-07-16-01165
- 04-16-2021
- Updated: Fraud Risk Indicator
- 04-15-2021
- Message from HHS-OIG Leadership on the COVID-19 Vaccination Program and Provider Compliance
- Mensaje de la PDIG sobre el programa de vacunaci�n contra el COVID-19 y (acatamiento) del proveedor
- Updated: Work Plan
- 04-13-2021
- Georgia Generally Ensured That Nursing Facilities Reported Allegations of Potential Abuse or Neglect of Medicaid Beneficiaries and Prioritized Allegations Timely A-04-17-03084
- 04-12-2021
- Blue Cross Blue Shield of South Carolina Overstated Its Supplemental Executive Retirement Plan III Medicare Allowable Segment Pension Assets as of January 1, 2017 A-07-20-00600
- Updated: Corporate Integrity Agreements
- 04-09-2021
- CNN Op-Ed by Christi A. Grimm & Michael E. Horowitz: Four crucial lessons for improving Covid-19 testing
- New COVID-19 Enforcement Actions
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2020 A-18-20-11200
- Palmetto Government Benefits Administrator, LLC, Overstated Its Excess Plan Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00598
- Noridian Healthcare Solutions, LLC, Claimed Unallowable Medicare Nonqualified Restoration Savings Plan Costs Through Its Incurred Cost Proposals A-07-20-00591
- Updated: Civil Monetary Penalties and Affirmative Exclusions, CIA Reportable Events, and Provider Self Disclosures
- 04-07-2021
- Summary Report for Cybersecurity Assessments of Four HHS Operating Division Networks A-18-20-08012
- 04-06-2021
- Medicare Advantage Organizations Are Missing Opportunities To Use Ordering Provider Identifiers To Protect Program Integrity OEI-03-19-00432
- 04-01-2021
- Medicare Hospital Provider Compliance Audit: Sunrise Hospital & Medical Center A-04-19-08075
March
- 03-30-2021
- An Ophthalmology Clinic in California: Audit of Medicare Payments for Eye Injections of Eylea and Lucentis A-09-19-03022
- Data on Medicaid Managed Care Payments to Providers Are Incomplete and Inaccurate OEI-02-19-00180
- 03-29-2021
- Illinois Medicaid Fraud Control Unit: 2019 Onsite Review OEI-06-19-00510
- 03-25-2021
- Companion Data Services, LLC, Properly Updated Its Excess Plan Medicare Segment Pension Assets as of January 1, 2017 A-07-21-00606
- Updated: Corporate Integrity Agreements
- 03-24-2021
- Hospitals Reported That the COVID-19 Pandemic Has Significantly Strained Health Care Delivery OEI-09-21-00140
- Updated: COVID-19 FAQs
- Advisory Opinion 21-01 (regarding a free drug provided by a pharmaceutical manufacturer to certain patients to whom the manufacturer's drug has been prescribed.)
- 03-19-2021
- Medicaid Fraud Control Units Fiscal Year 2020 Annual Report OEI-09-21-00120
- 03-18-2021
- North Mississippi Medical Center: Audit of Medicare Payments for Polysomnography Services A-04-19-07086
- Updated: Corporate Integrity Agreements
- 03-15-2021
- Updated: Work Plan
- 03-12-2021
- HHS Operating Division Generally Implemented Cybersecurity Controls Over Key Reporting System But Improvements Are Needed A-18-20-06001
- 03-11-2021
- CMS Use of Data on Nursing Home Staffing: Progress and Opportunities To Do More OEI-04-18-00451
- 03-10-2021
- LEIE Database Updated with February 2021 Exclusions and Reinstatements
- 03-08-2021
- Peninsula Regional Medical Center: Audit of Medicare Payments for Polysomnography Services A-04-19-07087
- Florida Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Assess, Prioritize, or Investigate Reported Incidents A-04-17-08058
- Updated: Provider Self-Disclosure Settlements
- Updated: Civil Monetary Penalties and Affirmative Exclusions
- Updated: Grant Fraud Self-Disclosure Settlements
- 03-05-2021
- Updated COVID-19 Fraud Alert Information
- Updated: Corporate Integrity Agreements
- 03-03-2021
- CMS Authorized Hundreds of Millions of Dollars in Advanced Premium Tax Credits on Behalf of Enrollees Who Did Not Make Their Required Premium Payments A-02-19-02005
- Updated: Corporate Integrity Agreements
- 03-02-2021
- ACF Cannot Ensure That All Child Victims of Abuse and Neglect Have Court Representation OEI-12-16-00120
- 03-01-2021
- STAT Op-Ed by Christi A. Grimm & Julie K. Taitsman: Why drug prescriptions should include diagnoses
February
- 02-26-2021
- Message from HHS-OIG Leadership on Telehealth
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Blue Cross Blue Shield of Michigan (Contract H9572) Submitted to CMS A-02-18-01028
- Updated: Corporate Integrity Agreements
- 2021 Fall OIG Health Care Fraud and Abuse Legal Internship
- 02-24-2021
- Medicare Hospice Provider Compliance Audit: Tidewell Hospice, Inc. A-02-18-01024
- Virginia's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 8 of 30 Providers Reviewed A-03-19-00253
- Trend Toward More Expensive Inpatient Hospital Stays in Medicare Emerged Before COVID-19 and Warrants Further Scrutiny OEI-02-18-00380
- Updated: Corporate Integrity Agreements
- 02-23-2021
- Although the Bemidji Area Office Had Adequate Procedures To Disburse Indian Health Service Funds, It Needs To Strengthen Its Procedures for Monitoring the Use of the Funds A-05-18-00019
- 02-22-2021
- Noridian Healthcare Solutions, LLC, Made Improper Medicare Payments of $4 Million to Physicians in Jurisdiction E for Spinal Facet-Joint Injections A-09-20-03010
- 02-18-2021
- Updated: Provider Self-Disclosure Settlements
- 02-17-2021
- New York Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-02-17-01026
- Updated: Corporate Integrity Agreements
- Updated: COVID-19 FAQs
- 02-16-2021
- Iowa Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-07-19-03238
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2020 OEI-03-21-00060
- Updated: Work Plan
- 02-11-2021
- Illinois Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00031
- 02-10-2021
- LEIE Database Updated with January 2021 Exclusions and Reinstatements
- 02-04-2021
- Opioid Use in Medicare Part D During the Onset of the COVID-19 Pandemic OEI-02-20-00400
- Updated: Corporate Integrity Agreements
- 02-02-2021
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated Civil Monetary Penalties and Affirmative Exclusions
January
- 01-29-2021
- Louisiana Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries A-06-18-02000
- Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings A-04-21-06248
- Updated: Work Plan
- 01-28-2021
- California Claimed at Least $2 Million in Unallowable Medicaid Reimbursement for a Selected Provider's Opioid Treatment Program Services A-09-20-02001
- Massachusetts Made at Least $14 Million in Improper Medicaid Payments for the Nonemergency Medical Transportation Program A-01-19-00004
- 01-25-2021
- Updated Provider Self-Disclosure Settlements
- Updated: Corporate Integrity Agreements
- 01-20-2021
- Choctaw Nation of Oklahoma Made Progress Toward Meeting Program Goals During the First Year of Its Tribal Opioid Response Grant A-07-20-04121
- 01-21-2021
- Independent Attestation Review: Substance Abuse and Mental Health Services Administration Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00353
- 01-20-2021
- Updated: Work Plan
- 01-19-2021
- CMS and Its Contractors Did Not Use Comprehensive Error Rate Testing Program Data To Identify and Focus on Error-Prone Providers A-05-17-00023
- 01-15-2021
- Medicare Home Health Agency Provider Compliance Audit: Southeastern Home Health Services
- Updated: Work Plan
- 01-14-2021
- Federal COVID-19 Testing Report: Data Insights from Six Federal Health Programs
- Updated: Fraud Risk Indicator
- 01-13-2021
- Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00355
- Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00354
- Independent Attestation Review: National Institutes of Health Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00352
- Independent Attestation Review: Indian Health Service Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00351
- 01-08-2021
- Updated: Corporate Integrity Agreements
- 01-07-2021
- LEIE Database Updated with December 2020 Exclusions and Reinstatements
- Ohio Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program A-05-18-00004
- 01-05-2021
- Updated: Corporate Integrity Agreements
-
December
- 12-31-2020
- The Centers for Medicare & Medicaid Services Could Improve Its Wage Index Adjustment for Hospitals in Areas With the Lowest Wages
- Advisory Opinion 20-09 (regarding a program where a pharmaceutical manufacturer provides financial assistance for travel, lodging, and other expenses to certain patients prescribed the manufacturer's drug)
- 12-30-2020
- Advisory Opinion 20-08 (regarding a federally qualified health center�s proposal to offer gift cards to incentivize certain pediatric patients to attend rescheduled preventive and early intervention care appointments)
- 12-29-2020
- Updated: Corporate Integrity Agreements
- 12-28-2020
- Advisory Opinion 20-07 (regarding a web-based platform where health care facilities and clinicians would, in particular circumstances, remit to patients and the patients' payors a portion of the claims for certain services for which payment may be made by the Medicare program as a secondary payor)
- Medicare Home Health Agency Provider Compliance Audit: Tender Touch Health Care Services A-04-18-07077
- States Could Do More to Oversee Spending and Contain Medicaid Costs for Specialty Drugs OEI-03-17-00430
- 12-23-2020
- Advisory Opinion 20-06 (regarding a management company's provision of below fair market value Medicaid enrollment application assistance services to certain individuals and affiliated skilled nursing facilities' payments for those services in particular circumstances)
- Aspects of Texas' Quality Incentive Payment Program Raise Questions About Its Ability To Promote Economy and Efficiency in the Medicaid Program A-06-18-07001
- 12-22-2020
- Onsite Surveys of Nursing Homes During the COVID-19 Pandemic: March 23-May 30, 2020 OEI-01-20-00430
- Despite Savings on Many Lab Tests in 2019, Total Medicare Spending Increased Slightly Because of Increased Utilization for Certain High-Priced Tests OEI-09-20-00450
- 12-21-2020
- The Office of Refugee Resettlement Did Not Award and Manage the Homestead Influx Care Facility Contracts in Accordance With Federal Requirements A-12-20-20001
- Indian Health Service Facilities Made Progress Incorporating Patient Protection Policies, but Challenges Remain OEI-06-19-00331
- Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Tullahoma, Tennessee A-02-16-01024
- Updated: Corporate Integrity Agreements
- 12-18-2020
- Medicare Hospital Provider Compliance Audit: Providence Medical Center A-07-18-05113
- 12-16-2020
- Opioids in Medicaid: Concerns About Opioid Use Among Beneficiaries in Six Appalachian States OEI-05-19-00410
- Medicare Home Health Agency Provider Compliance Audit: Total Patient Care Home Health, LLC A-06-16-05005
- HHS Operating Division Needs to Improve Controls Over Key Application to Protect Sensitive Data A-18-19-06002
- 12-15-2020
- Updated: Work Plan
- 12-14-2020
- Incidence of Adverse Events in Indian Health Service Hospitals OEI-06-17-00530
- Instances of IHS Labor and Delivery Care Not Following National Clinical Guidelines or Best Practices OEI-06-19-00190
- Although CDC Implemented Corrective Actions To Improve Oversight of the President's Emergency Plan for AIDS Relief Recipients, Some Internal Control Weaknesses Remained A-04-18-01010
- Risk Assessment Puerto Rico Medicaid Program A-02-20-01011
- Updated COVID-19 FAQs
- 12-11-2020
- New York Improved Its Monitoring of Its Personal Care Services Program But Still Made Improper Medicaid Payments of More Than $54 Million A-02-19-01016
- 12-10-2020
- Updated COVID-19 FAQs
- LEIE Database Updated with November 2020 Exclusions and Reinstatements
- Few Patients Received High Amounts of Opioids from IHS-Run Pharmacies OEI-05-18-00470
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2019 in Accordance With Federal Requirements A-04-20-04077
- 12-09-2020
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated Provider Self-Disclosure Settlements
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 12-08-2020
- New York Provided Projects for Assistance in Transition From Homelessness Grant Services to Ineligible Individuals and Did Not Contribute Any Required Non-Federal Funds A-02-19-02006
- 12-04-2020
- Updated: Corporate Integrity Agreements
- 12-03-2020
- Updated COVID-19 Fraud Alert
- 12-02-2020
- 2020 Fall Semiannual Report to Congress
- Press Release: HHS-OIG�s Work Could Save Taxpayers Billions of Dollars, New Report Says
- Nebraska Claimed Almost All Medicaid Payments for Targeted Case Management Services in Accordance With Federal Requirements but Claimed Some Unallowable Duplicate Payments A-07-19-03239
November
- 11-27-2020
- Florida Received Unallowable Medicaid Reimbursement for School-Based Services A-04-18-07075
- 11-24-2020
- U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement A-17-20-54000
- 11-23-2020
- Opioid Treatment Programs Reported Challenges Encountered During the COVID-19 Pandemic and Actions Taken To Address Them A-09-20-01001
- Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Payson, Arizona. A-02-16-01023
- Updated COVID-19 Fraud Alert
- 11-20-2020
- Final Rule: Medicare and State Health Care Programs: Fraud and Abuse; Revisions to Safe Harbors under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements
- Medicare Home Health Agency Provider Compliance Audit: The Palace at Home A-04-17-07067
- Updated: Corporate Integrity Agreements
- 11-19-2020
- Ohio Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00023
- Medicare Hospital Provider Compliance Audit: Edward W. Sparrow Hospital A-05-18-00045
- 11-18-2020
- Cahaba Government Benefits Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00577
- Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00578
- Hospitals Did Not Comply With Medicare Requirements for Reporting Cardiac Device Credits A-01-18-00502
- 11-17-2020
- 2020 Top Management and Performance Challenges Facing HHS
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2020 OEI-03-21-00050
- 11-16-2020
- Updated: Work Plan
- Special Fraud Alert: Speaker Programs
- In Selected States, 67 of 100 Health Centers Did Not Use Their HRSA Access Increases in Mental Health and Substance Abuse Services Grant Funding in Accordance With Federal Requirements A-02-19-02001
- Updated: Corporate Integrity Agreements
- 11-12-2020
- Ohio Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries A-05-18-00027
- Updated: Corporate Integrity Agreements
- 11-10-2020
- Advocating for the Nation's Elder Population: Operation CARE
- Updated: Corporate Integrity Agreements
- LEIE Database Updated with October 2020 Exclusions and Reinstatements
- 11-09-2020
- Office of Refugee Resettlement Ensured That Selected Care Providers Were Prepared To Respond to the COVID-19 Pandemic A-04-20-02031
- 11-06-2020
- Cahaba Government Benefits Administrators, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00575
- Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00576
- CMS Did Not Ensure That Medicare Hospital Payments for Claims That Included Medical Device Credits Were Reduced in Accordance With Federal Regulations, Resulting in as Much as $35 Million in Overpayments A-07-19-00560
- 11-03-2020
- Updated: Corporate Integrity Agreements
- 11-02-2020
- Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Central Jersey Home Care and Hospice, Inc. A-02-17-01025
- Updated: Corporate Integrity Agreements
- 10-30-2020
- Minnesota Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00018
- Medicare Hospital Provider Compliance Audit: St Francis Hospital A-05-18-00048
- 10-27-2020
- Updated: Corporate Integrity Agreements
- 10-26-2020
- Updated: Work Plan
- Massachusetts Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-06-18-04001
- Updated: Corporate Integrity Agreements
- 10-23-2020
- Medicare Home Health Agency Provider Compliance Audit: Gem City Home Care, LLC A-05-18-00011
- 10-16-2020
- Cedars-Sinai Medical Center: Audit of Medicare Payments for Bariatric Surgeries A-09-18-03010
- 10-15-2020
- Updated: Work Plan
- 10-13-2020
- Medicare Improperly Paid Physicians for More Than Five Spinal Facet-Joint Injection Sessions During a Rolling 12-Month Period A-09-20-03003
- 10-09-2020
- Update on Oversight of Opioid Prescribing and Monitoring of Opioid Use: States Have Taken Action To Address the Opioid Epidemic A-09-20-01000
- Updated: Fraud Risk Indicator
- 10-08-2020
- LEIE Database Updated with September 2020 Exclusions and Reinstatements
- Remarks: 2020 Health Care Fraud Takedown
- 10-07-2020
- Updated: Corporate Integrity Agreements
- 10-06-2020
- HHS Made Some Progress Toward Compliance With the Geospatial Data Act A-18-20-11500
- Colorado Improperly Claimed Millions in Enhanced Federal Medicaid Reimbursement for New Adult Group Beneficiaries Because of a Data Processing Error A-07-17-02807
- Medicare Critical Care Services Provider Compliance Audit: Clinical Practices of the University of Pennsylvania A-03-18-00003
- 10-05-2020
- Speech: Connecting the Dots: An OIG Update, by Christi A. Grimm, Principal Deputy Inspector General
- 10-02-2020
- Risk Assessment of Food and Drug Administration's Purchase Card Program A-04-19-06234
- Medicare Hospital Provider Compliance Audit: Alta Bates Summit Medical Center A-04-19-08071
- Updated: Corporate Integrity Agreements
- 10-01-2020
- Updated: Work Plan
- National Snapshot of State Agency Approaches to Child Care During the COVID-19 Pandemic A-07-20-06092
- Youth For Tomorrow - New Life Center, Inc., an Administration for Children and Families Grantee, Did Not Comply With All Applicable Federal Policies and Requirements A-03-16-00250
- 09-30-2020
- 2020 National Health Care Fraud Takedown
- 09-29-2020
- FDA's Risk Evaluation and Mitigation Strategies: Uncertain Effectiveness in Addressing the Opioid Crisis OEI-01-17-00510
- North Carolina Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-04-16-00112
- 09-28-2020
- Healthcare Dive Op-Ed by Christi A. Grimm: Medicare Advantage should not 'game the system' but prioritize patient care, honest billing
- Updated: Corporate Integrity Agreements
- 09-25-2020
- States Continued To Fall Short in Meeting Required Timeframes for Investigating Nursing Home Complaints: 2016-2018 OEI-01-19-00421
- 09-24-2020
- Updated: Corporate Integrity Agreements
- Connecticut Did Not Meet Federal and State Requirements for Claiming Medicaid School-Based Child Health Services for Hartford Public Schools A-01-19-00003
- CMS's Monitoring Activities for Ensuring That Medicare Accountable Care Organizations Report Complete and Accurate Data on Quality Measures Were Generally Effective, but There Were Weaknesses That Could Be Improved A-09-18-03033
- 09-23-2020
- Advisory Opinion 20-05 (regarding a pharmaceutical manufacturer's proposal to provide cost-sharing assistance directly to Medicare beneficiaries who are prescribed either of two formulations of its drug)
- CMS Should Pursue Strategies To Increase the Number of At Risk Beneficiaries Acquiring Naloxone Through Medicaid OEI-BL-18-00360
- Arkansas Medicaid Fraud Control Unit: 2019 Onsite Inspection OEI-12-19-00450
- Oregon's Oversight Did Not Ensure That Four Coordinated-Care Organizations Complied With Selected Medicaid Requirements Related to Access to Care and Quality of Care A-09-18-03035
- Updated: Corporate Integrity Agreements
- 09-22-2020
- North Carolina Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-19-08070
- Vermont Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-19-06086
- 09-21-2020
- Updated: Work Plan
- Updated: Corporate Integrity Agreements
- Illinois Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-05-18-00037
- Incorrect Acute Stroke Diagnosis Codes Submitted by Traditional Medicare Providers Resulted in Millions of Dollars in Increased Payments to Medicare Advantage Organizations A-07-17-01176
- 09-18-2020
- Updated: Corporate Integrity Agreements
- Medicare-Allowed Charges for Noninvasive Ventilators Are Substantially Higher Than Payment Rates of Select Non-Medicare Payers A-05-20-00008
- Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals A-07-20-00590
- 09-17-2020
- Southwest Key Programs Failed To Protect Federal Funds Intended for the Care and Placement of Unaccompanied Alien Children A-06-17-07004
- Indiana Did Not Ensure That Medicaid Payments Were Made Properly for Some Claims Identified as Having Third-Party Coverage A-05-18-00046
- Medicare Home Health Agency Provider Compliance Audit: Mercy Health Visiting Nurse Services A-05-18-00035
- 09-16-2020
- Maine Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-18-06079
- Group Health Incorporated Overstated Its Allowable Medicare Supplemental Executive Retirement Plan Costs for Calendar Years 2009 Through 2016 A-07-19-00582
- Group Health Incorporated Claimed Some Unallowable Medicare Postretirement Benefit Costs for Calendar Years 2009 Through 2016 A-07-19-00583
- 09-15-2020
- Updated: Work Plan
- Group Health Incorporated Overstated Its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of December 31, 2015 A-07-19-00579
- Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of August 31, 2016 A-07-19-00580
- Group Health Incorporated Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2009 Through 2016 A-07-19-00581
- Some Manufacturers Reported Inaccurate Drug Product Data to CMS OEI-03-19-00200
- 09-14-2020
- The National Institutes of Health Should Improve Its Stewardship and Accountability Over Hardware and Software Assets A-18-19-06004
- 09-11-2020
- Baylor Scott & White—College Station: Audit of Outpatient Outlier Payments A-06-18-04003
- 09-10-2020
- LEIE Database Updated with August 2020 Exclusions and Reinstatements
- Billions in Estimated Medicare Advantage Payments From Diagnoses Reported Only on Health Risk Assessments Raise Concerns OEI-03-17-00471
- Updated: Provider Self-Disclosure Settlements
- 09-09-2020
- Updated Civil Monetary Penalties and Affirmative Exclusions
- Audit of Medicare Part D Pharmacy Fees: Horizon Blue Cross Blue Shield, Inc. A-03-18-00007
- 09-04-2020
- Hawaii's Monitoring Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements A-09-19-01000
- National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded in 2019 OEI-07-20-00180
- 09-03-2020
- Updated COVID-19 FAQs
- Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group A-07-19-02822
- Medicare Hospital Provider Compliance Audit: Flagstaff Medical Center A-07-18-05112
- 09-02-2020
- Tribal Health Programs: Concerns About Background Verifications for Staff Working With Indian Children A-01-20-01500
- CMS Generally Met Requirements for the DMEPOS Competitive Bidding Program Round 1 Recompete A-05-16-00051
- 09-01-2020
- Indiana's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 17 of 30 Providers Reviewed A-05-19-00012
- Michigan Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00017
- Illinois Claimed Unallowable Telemedicine Payments A-05-18-00028
- Indiana Paid $3.5 Million for Medicaid Nonemergency Medical Transport Claims That Did Not Comply With Federal and State Requirements A-05-18-00043
- 08-31-2020
- Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria Fiscal Year 2021 Inspectors General Coordinated PEPFAR Oversight Plan U.S. Department of Health and Human Services, Office of Inspector General A-04-20-01017
- 08-28-2020
- Updated: Work Plan
- Texas Relied on Impermissible Provider-Related Donations To Fund the State Share of the Medicaid Delivery System Reform Incentive Payment Program A-06-17-09002
- 08-27-2020
- Medicare Contractors Were Not Consistent in How They Reviewed Extrapolated Overpayments in the Provider Appeals Process A-05-18-00024
- 08-26-2020
- Updated: Work Plan
- CMS's Encounter Data Lack Essential Information That Medicare Advantage Organizations Have the Ability to Collect OEI-03-19-00430
- 08-25-2020
- Indiana Properly Reported Adjustments Related to the Drug Rebate Program A-05-19-00028
- 08-24-2020
- Updated: Corporate Integrity Agreements
- 08-21-2020
- Rhode Island's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 18 of 30 Providers Reviewed A-01-18-02505
- Updated: Corporate Integrity Agreements
- 08-20-2020
- Updated: Fraud Risk Indicator
- New Jersey Did Not Ensure That Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries Residing in Nursing Facilities Were Always Properly Investigated and Reported A-02-18-01006
- 08-18-2020
- Nebraska Claimed Unallowable School-Based Administrative Costs Because of Improper Coding of Random Moment Timestudy Responses A-07-19-03234
- Medicare Home Health Agency Provider Compliance Audit: Mission Home Health of San Diego, Inc. A-09-18-03008
- 08-17-2020
- Updated: Work Plan
- Opioid Use in Medicare Part D Continued To Decline in 2019, but Vigilance Is Needed as COVID-19 Raises New Concerns OEI-02-20-00320
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2018 Average Sales Prices OEI-03-20-00130
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2020 OEI-03-20-00060
- 08-14-2020
- Medicare Laboratory Test Expenditures Increased in 2018, Despite New Rate Reductions (OEI-09-19-00100)
- 08-12-2020
- Visionquest Industries, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03010
- Medicare Home Health Agency Provider Compliance Audit: Condado Home Care Program, Inc. A-02-17-01022
- 08-11-2020
- OIG's Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs
- 08-10-2020
- Desoto Home Health Care, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03021
- 08-07-2020
- Inadequate Edits and Oversight Caused Medicare To Overpay More Than $267 Million for Hospital Inpatient Claims With Post-Acute-Care Transfers to Home Health Services A-04-18-04067
- 08-06-2020
- LEIE Database Updated with July 2020 Exclusions and Reinstatements
- Some Nursing Homes' Reported Staffing Levels in 2018 Raise Concerns; Consumer Transparency Could Be Increased OEI-04-18-00450
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2019 A-18-20-11300
- Updated: Corporate Integrity Agreements
- 08-05-2020
- Updated: Provider Self-Disclosure Settlements
- Updated: Corporate Integrity Agreements
- 08-04-2020
- Updated COVID-19 FAQs
- 08-03-2020
- Emergency Response Toolkits: Key Insights and Lessons Learned
- 07-31-2020
- North Carolina Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse and Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Timely A-04-17-04063
- 07-30-2020
- Kansas Did Not Ensure That Group Homes for Children in Foster Care Complied With All State Health and Safety Requirements A-07-19-06087
- Factsheet: Ohio's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-05-19-00036
- UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- 07-29-2020
- The New York State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-04-19-06223
- 07-28-2020
- New Jersey's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 9 of 30 Providers Reviewed A-02-19-02004
- 07-27-2020
- Updated: Work Plan
- Updated Corporate Integrity Agreements
- 07-24-2020
- Utah's Monitoring Process Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements A-07-19-06085
- On-Site Psychological Services, P.C.: Audit of Medicare Payments for Psychotherapy Services A-02-19-01012
- Alaska Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-09-19-02001
- Advisory Opinion 20-04 (regarding a charitable organization's proposal to purchase or receive donations of unpaid medical debt owed by qualifying patients from certain types of health care providers and then forgive that debt)
- Updated Corporate Integrity Agreements
- 07-23-2020
- CMS Could Have Saved $192 Million by Targeting Home Health Claims for Review With Visits Slightly Above the Threshold That Triggers a Higher Medicare Payment A-09-18-03031
- HRSA's Monitoring Did Not Always Ensure Health Centers' Compliance With Federal Requirements for HRSA's Access Increases In Mental Health and Substance Abuse Services Supplemental Grant Funding A-02-18-02010
- 07-22-2020
- FY 2019 Health Care Fraud and Abuse Control Program Report
- 07-16-2020
- CMS Did Not Administer and Manage Strategic Communications Services Contracts in Accordance With Federal Requirements A-12-19-20003
- Ohio Did Not Ensure the Accuracy and Completeness of Psychotropic and Opioid Medication Information Recorded in Its Child Welfare Information System for Children in Foster Care A-05-18-00007
- 07-15-2020
- Updated: Work Plan
- Hospitals Overbilled Medicare $1 Billion by Incorrectly Assigning Severe Malnutrition Diagnosis Codes to Inpatient Hospital Claims A-03-17-00010
- Updated Corporate Integrity Agreements
- 07-14-2020
- Medicaid Data Can Be Used To Identify Instances of Potential Child Abuse or Neglect A-01-19-00001
- 07-13-2020
- Texas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-04003
- Updated Corporate Integrity Agreements
- 07-10-2020
- LEIE Database Updated with June 2020 Exclusions and Reinstatements
- Sharon Baptist Head Start Claimed Unallowable Rent and Failed To Return Embezzled Funds A-02-17-02003
- 07-09-2020
- Updated Corporate Integrity Agreements
- 07-08-2020
- Freedom Orthotics, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03012
- Loophole in Drug Payment Rule Continues To Cost Medicare and Beneficiaries Hundreds of Millions of Dollars OEI-BL-20-00100
- Updated: Fraud Risk Indicator
- Updated: Provider Self-Disclosure Settlements
- 07-07-2020
- 2019 Performance Data for the Senior Medicare Patrol Projects OEI-02-20-00150
- Updated Corporate Integrity Agreements
- 07-02-2020
- Updated Corporate Integrity Agreements
- Updated: Work Plan
- 07-01-2020
- Advisory Opinion 20-03 (regarding an arrangement under which a discount medical plan organization ("DMPO") pays chiropractors and chiropractic clinics a fee for each new DMPO member referred by the chiropractor or chiropractic clinic)
- 06-30-2020
- Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2020 OEI-05-20-00190
- 06-26-2020
- Hawaii Medicaid Fraud Control Unit: 2019 Onsite Review OEI-06-19-00110
- Updated: Fraud Risk Indicator
- 06-23-2020
- Updated: Work Plan
- 06-19-2020
- Updated Corporate Integrity Agreements
- 06-18-2020
- Unaccompanied Alien Children Program Care Provider Facilities Do Not Include All Required Security Measures in Their Checklists OEI-05-19-00210
- The Office of Refugee Resettlement's Incident Reporting System Is Not Effectively Capturing Data To Assist Its Efforts To Ensure the Safety of Minors in HHS Custody OEI-09-18-00430
- Press Release: HHS-OIG: Significant Incidents Involving Unaccompanied Children Not Effectively Captured in Reporting System; Facility Physical Security Inspection Checklists Need Improvement
- View a timeline detailing OIG's national review of the UAC Program
- 06-15-2020
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated: Work Plan
- 06-10-2020
- LEIE Database Updated with May 2020 Exclusions and Reinstatements
- Updated Provider Self-Disclosure Settlements
- 06-09-2020
- Updated Corporate Integrity Agreements
- 06-08-2020
- Texas Telemedicine Services Were Provided in Accordance with State Requirements A-06-18-05001
- Medicare Hospital Provider Compliance Audit: The Ohio State University Hospital A-05-18-00042
- 06-05-2020
- HHS Should Address Gaps in Incident Response Capabilities Across the Department A-18-17-04002
- 06-04-2020
- Updated Corporate Integrity Agreements
- 06-03-2020
- The National Cancer Institute Needs To Strengthen Procedures in Its Pre-Award Process To Assess Risk for Higher Risk Applicants A-03-19-03004
- New Jersey Did Not Ensure That Its Managed Care Organizations Adequately Assessed and Covered Medicaid Beneficiaries' Needs for Long-Term Services and Supports A-02-17-01018
- 06-01-2020
- Spring 2020 Semiannual Report to Congress
- 05-28-2020
- Updated Corporate Integrity Agreements
- 05-27-2020
- The National Eye Institute Generally Had Adequate Procedures To Assess an Applicant's Risk During the Pre-Award Process A-05-19-00017
- 05-26-2020
- COVID-19 Response Strategic Plan
- Opening Statement for Christi Grimm, Principal Deputy Inspector General, Office of Inspector General, U.S. House Committee on Oversight and Reform: Oversight Related to Coronavirus Response Efforts
- 05-22-2020
- Updated: Work Plan
- Updated Corporate Integrity Agreements
- 05-14-2020
- UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- 05-13-2020
- Updated Corporate Integrity Agreements
- 05-12-2020
- U.S. Department of Health and Human Services Met Many Requirements of the Improper Payments Information Act of 2002 but Did Not Fully Comply for Fiscal Year 2019 A-17-20-52000
- 05-08-2020
- LEIE Database Updated with April 2020 Exclusions and Reinstatements
- UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- HHS Operating Division Needs to Improve Security Controls to More Effectively Prevent Cyberattacks A-18-18-08400
- 05-07-2020
- HHS OIG Toolkits for Calculating Opioid Levels and Identifying Patients At Risk of Misuse or Overdose
- Medicare Part D Beneficiaries at Serious Risk of Opioid Misuse or Overdose: A Closer Look OEI-02-19-00130
- Updated Provider Self-Disclosure Settlements
- 05-06-2020
- Updated Corporate Integrity Agreements
- 05-05-2020
- Illinois' Monitoring Did Not Ensure Childcare Provider Compliance With State Criminal Background Check Requirements at 12 of 30 Providers Reviewed A-05-19-00016
- Medicare Made $11.7 Million in Overpayments for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays A-01-17-00508
- 05-04-2020
- Selected Health Care Coalitions Increased Involvement in Whole Community Preparedness But Face Developmental Challenges Following New Requirements in 2017 OEI-04-18-00080
- 05-01-2020
- North Carolina Received $30 Million in Excess Federal Funds Related to Improperly Claimed Health Home Expenditures A-04-18-00120
- UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- 04-30-2020
- Updated Corporate Integrity Agreements
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 04-28-2020
- Updated: Work Plan
- 04-24-2020
- UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- 04-23-2020
- UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- 04-22-2020
- Grand Desert Psychiatric Services: Audit of Medicare Payments for Psychotherapy Services A-09-19-03018
- Recommendation Followup: Michigan Did Not Report and Refund the Full Federal Share of Medicaid Overpayments A-05-18-00022
- 04-21-2020
- Grants, Contracts, and Other Agreements: Fraud and Abuse; Information Blocking; Office of Inspector General's Civil Money Penalty Rules
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs A-07-20-00589
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Pension Costs A-07-20-00588
- Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00587
- Palmetto Government Benefits Administrator, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00586
- HHS Operating Division Needs to Improve Information Technology Continuity Planning A-18-18-04005
- 04-20-2020
- Cape Cod Child Development Program Did Not Meet Its Head Start Non-Federal Share Obligations A-01-19-02500
- Updated Corporate Integrity Agreements
- 04-17-2020
- Updated Corporate Integrity Agreements
- 04-15-2020
- Mississippi Needs To Improve Oversight of Its Child Care Payment Program A-07-18-04111
- 96 Percent of South Carolina's Medicaid Fee-for-Service Telemedicine Payments Were Insufficiently Documented or Otherwise Unallowable A-04-18-00122
- Updated Corporate Integrity Agreements
- Updated: Work Plan
- 04-14-2020
- Medicare Home Health Agency Provider Compliance Audit: Residential Home Health A-05-16-00063
- Updated Corporate Integrity Agreements
- 04-13-2020
- An Estimated 87 Percent of Inpatient Psychiatric Facility Claims With Outlier Payments Did Not Meet Medicare's Medical Necessity or Documentation Requirements A-01-16-00508
- Most Indian Health Service Purchased/Referred Care Program Claims Were Not Reviewed, Approved, and Paid in Accordance With Federal Requirements
- 04-10-2020
- LEIE Database Updated with March 2020 Exclusions and Reinstatements
- 04-09-2020
- New York Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-02-18-01016
- Iowa Inadequately Monitored Its Medicaid Health Home Providers, Resulting in Tens of Millions in Improperly Claimed Reimbursement A-07-18-04109
- Updated Fraud Risk Indicator
- 04-07-2020
- Updated Corporate Integrity Agreements
- Updated Provider Self-Disclosure Settlements
- Updated CIA Reportable Events
- Updated: Work Plan
- 04-06-2020
- Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020 OEI-06-20-00300
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2018 in Accordance With Federal Requirements A-04-19-04072
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2019 A-18-19-11200
- New Hampshire's Monitoring Did Not Ensure Childcare Provider Compliance With State Criminal Background Check Requirements at 21 of 30 Providers Reviewed A-01-18-02504
- 04-03-2020
- OIG Policy Statement Regarding Application of Certain Administrative Enforcement Authorities Due to Declaration of Coronavirus Disease 2019 (COVID-19) Outbreak in the United States as a National Emergency
- FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- NIH Has Acted To Protect Confidential Information Handled by Peer Reviewers, But It Could Do More OEI-05-19-00240
- 04-01-2020
- States Could Do More To Prevent Terminated Providers From Serving Medicaid Beneficiaries OEI-03-19-00070
- Twenty-Three States Reported Allowing Unenrolled Providers To Serve Medicaid Beneficiaries OEI-05-19-00060
- 03-31-2020
- New York's Oversight of Medicaid Managed Care Organizations Did Not Ensure Providers Complied With Health and Safety Requirements at 18 of 20 Adult Day Care Facilities Reviewed A-02-18-01027
- Medicare Hospital Provider Compliance Audit: Forbes Hospital A-03-18-00005
- Updated Civil Monetary Penalties and Affirmative Exclusions
- Updated CIA Reportable Events
- 03-30-2020
- OIG Strategic Plan 2020–2025
- Message from leadership on minimizing burdens on providers
- Iowa Did Not Comply With Federal and State Requirements for Major Incidents Involving Medicaid Members With Developmental Disabilities A-07-18-06081
- 03-27-2020
- At A Glance: Medicaid Fraud Control Units Fiscal Year 2019 Annual Report
- Medicare Dialysis Services Provider Compliance Review: Bio-Medical Applications of Arecibo, Inc. A-02-17-01016
- Risk Assessment of HHS Grant Closeout Procedures A-04-19-08072
- Updated Corporate Integrity Agreements
- 03-26-2020
- Most of the Non-Newly Eligible Beneficiaries for Whom Colorado Made Medicaid Payments Met Federal and State Requirements, but Documentation Supporting That All Eligibility Requirements Were Verified Properly Was Not Always in Place A-07-18-02812
- Office of Counsel inquiries should be directed to officeofcounsel@oig.hhs.gov
- 03-24-2020
- FAQ: Waiving Telehealth Cost-Sharing During COVID-19 Outbreak
- Florida Made Almost $4 Million in Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid ID Numbers A-04-18-07080
- Updated Corporate Integrity Agreements
- 03-23-2020
- Fraud Alert: COVID-19 Scams
- Montana Medicaid Fraud Control Unit: 2019 Onsite Inspection OEI-12-19-00170
- Updated: Work Plan
- 03-20-2020
- Updated Corporate Integrity Agreements
- 03-19-2020
- CMS Could Take Actions To Help States Comply With Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions A-09-18-02004
- 03-18-2020
- States' Use of Grant Funding for a Targeted Response to the Opioid Crisis OEI-BL-18-00460
- 03-17-2020
- Waiving Telehealth Cost-Sharing During COVID-19 Outbreak
- Missouri Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-07-18-03230
- 03-16-2020
- The National Institutes of Health Has Controls to Mitigate the Risk That Grantees Receive Duplicate Grant Funding A-02-19-02002
- Updated Corporate Integrity Agreements
- Updated Civil Monetary Penalties and Affirmative Exclusions
- Updated: Work Plan
- 03-11-2020
- Updated Corporate Integrity Agreements
- 03-10-2020
- LEIE Database Updated with February 2020 Exclusions and Reinstatements
- Factsheet: Kentucky's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-04-19-02022
- SAMHSA's Oversight of Accreditation Bodies for Opioid Treatment Programs Did Not Comply With Some Federal Requirements A-09-18-01007
- Key Medicare Tools To Safeguard Against Pharmacy Fraud and Inappropriate Billing Do Not Apply to Part D OEI-02-15-00440
- Florida Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-18-08065
- 03-09-2020
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2019 OEI-03-20-00040
- 03-05-2020
- Communication and Management Challenges Impeded HHS's Response to the Zero-Tolerance Policy OEI-BL-18-00510
- Press Release: HHS OIG: Communication and Management Challenges Impeded HHS's Response to Zero-Tolerance Policy
- 03-04-2020
- Medicare Hospital Provider Compliance Audit: Saint Francis Health Center A-07-17-05102
- Updated Provider Self-Disclosure Settlements
- 03-03-2020
- New Mexico's Monitoring of Childcare Providers Generally Ensured Provider Compliance With State Criminal Background Check Requirements at 30 Childcare Providers Reviewed A-06-19-07001
- The Centers for Medicare & Medicaid Services Did Not Identify and Report Potential Antideficiency Act Violations for 12 Contracts Used To Establish the Federal Marketplace Under the Affordable Care Act A-03-16-03001
- Updated Corporate Integrity Agreements
- 03-02-2020
- CHI St. Vincent Infirmary: Audit of Outpatient Outlier Payments A-06-16-01002
- National Institutes of Health Had Information Technology Control Weaknesses Surrounding Its Electronic Health Record System A-18-19-06003
- 02-27-2020
- Testimony of Suzanne Murrin, Deputy Inspector General, Office of Evaluation and Inspections, Office of Inspector General, U.S. House Committee on Appropriations, Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies: Oversight of the Food and Drug Administration
- 02-26-2020
- Ownership—But Not Physical Movement—of Selected Drugs Can Be Traced Through the Supply Chain OEI-05-17-00460
- New York Made Unallowable Payments Totaling More Than $10 Million for Managed Care Beneficiaries Assigned Multiple Medicaid Identification Numbers A-02-18-01020
- New York Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-02-18-01011
- 02-24-2020
- OCIG Job Posting: Senior Counsel for Exclusions
(Washington, DC) - Deadline 02/28/2020 - 02-21-2020
- Updated Corporate Integrity Agreements
- 02-20-2020
- Michigan Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-05-17-00048
- 02-18-2020
- Opportunities for Williamson and Burnet Counties Had Ineffective Accounting Controls and Used Unapproved or Questionable Cost Allocation Methods A-06-18-02002
- Updated: Work Plan
- 02-14-2020
- The Majority of Providers Reviewed Used Medicare Part D Eligibility Verification Transactions for Potentially Inappropriate Purposes A-05-17-00020
- Georgia's Monitoring of Childcare Providers Ensured Provider Compliance With State Criminal Background Check Requirements A-04-19-03580
- 02-13-2020
- The Indiana State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-05-19-00007
- Wateree Community Actions, Inc., Made Improvements but Still Requires Monitoring A-04-19-08069
- New York Followed Its Approved Methodology for Claiming Enhanced Medicaid Reimbursement Under the Community First Choice Option A-02-17-01015
- 02-12-2020
- The Federal Marketplace Properly Determined Individuals' Eligibility for Enrollment in Qualified Health Plans but Improperly Determined That an Estimated 3 Percent of Individuals Were Eligible for Insurance Affordability Programs A-09-18-01000
- 02-10-2020
- FY 2021 Congressional Budget Justification
- LEIE Database Updated with January 2020 Exclusions and Reinstatements
- Life Safety and Emergency Preparedness Deficiencies Found at 18 of 20 Texas Nursing Homes A-06-19-08001
- Job Opening: Associate Counsel for Exclusions (Washington, DC)
- 02-06-2020
- New York Claimed Tens of Millions of Dollars for Opioid Treatment Program Services That Did Not Comply With Medicaid Requirements Intended To Ensure the Quality of Care Provided to Beneficiaries A-02-17-01021
- Updated Provider Self-Disclosure Settlements
- 02-04-2020
- Missouri Medicaid Fraud Control Unit: 2018 Onsite Inspection OEI-12-18-00490
- 02-03-2020
- Geographic Disparities Affect Access to Buprenorphine Services for Opioid Use Disorder OEI-12-17-00240
- 01-30-2020
- More Than One-Third of New Jersey's Federal Medicaid Reimbursement for Providing Community-Based Treatment Services Was Unallowable A-02-17-01020
- 01-29-2020
- Medicare Market Shares of Diabetes Test Strips From April Through June 2019 OEI-04-19-00481
- 01-27-2020
- The National Institutes of Health Submitted OIG Clearance Documents for Just Over One-Half of Its Audit Recommendations, and the Remaining 225 Recommendations Were Unresolved as of September 30, 2016 A-07-19-03236
- CMS's Implementation of a 2014 Policy Change Resulted in Improvements in the Reporting of Coverage Gap Discounts Under Medicare Part D A-07-16-06067
- Tennessee's Monitoring Ensured Compliance With Criminal Background Check Requirements at 28 of the 30 Childcare Providers Reviewed A-04-19-02023
- 01-24-2020
- Advisory Opinion 20-02 (regarding financial assistance for travel, lodging, and other expenses provided by a pharmaceutical manufacturer to certain patients prescribed the manufacturer's drug)
- 01-23-2020
- Updated Corporate Integrity Agreements
- 01-22-2020
- Pennsylvania Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-03-17-00202
- Updated Corporate Integrity Agreements
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 01-17-2020
- Florida's Refugee Medical Assistance Payments Were Generally Allowable A-04-18-02010
- Novitas Solutions, Inc. Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances A-06-17-04002
- Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings A-04-19-06232
- 01-16-2020
- CMS's Controls Over Assigning Medicare Beneficiary Identifiers and Mailing New Medicare Cards Were Generally Effective but Could Be Improved in Some Areas A-09-19-03003
- 01-15-2020
- Updated Corporate Integrity Agreements
- Updated: Work Plan
- 01-14-2020
- New York Improperly Claimed Medicaid Reimbursement for Some Bridges to Health Waiver Program Services That Were Not in Accordance With an Approved Plan of Care and Did Not Meet Documentation Requirements A-02-18-01003
- 01-13-2020
- Advisory Opinion 20-01 (regarding a hospital's provision of discounted training to a specified fire department's personnel at the hospital's facility)
- 01-10-2020
- LEIE Database Updated with December 2019 Exclusions and Reinstatements
- Updated Provider Self-Disclosure Settlements
- 01-06-2020
- Updated Corporate Integrity Agreements
- 01-03-2020
- Updated Corporate Integrity Agreements
October
September
August
July
June
May
April
March
February
January
-
December
- 12-23-2019
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 12-20-2019
- Indian Health Service Has Strengthened Patient Protection Policies but Must Fully Integrate Them Into Practice and Organizational Culture OEI-06-19-00330
- 12-18-2019
- Video: Healthcare Fraud: What You Need To Know
- 12-17-2019
- Advisory Opinion 19-06 (regarding a supermarket's proposal to expand its current loyalty program to allow customers to earn rewards points on out-of-pocket costs paid in connection with pharmacy purchases)
- 12-16-2019
- Eye on Oversight: 2019 Year in Review
- CMS Made an Estimated $93.6 Million in Incorrect Medicare Electronic Health Record Incentive Payments to Acute-Care Hospitals, or Less Than 1 Percent of $10.8 Billion in Total Incentive Payments A-09-18-03020
- California Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program A-09-18-01006
- Medicare Home Health Agency Provider Compliance Audit: Palos Community Hospital Home Health Agency A-05-17-00022
- Updated: Work Plan
- 12-13-2019
- Medicare Hospital Provider Compliance Audit: Texas Health Presbyterian Hospital Dallas A-04-18-08068
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 12-12-2019
- Billions in Estimated Medicare Advantage Payments From Chart Reviews Raise Concerns OEI-03-17-00470
- Updated Corporate Integrity Agreements
- 12-10-2019
- LEIE Database Updated with November 2019 Exclusions and Reinstatements
- 12-06-2019
- Medicare Hospital Provider Compliance Audit: St. Vincent Hospital A-05-18-00040
- 12-04-2019
- Factsheet: Alabama's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-04-19-00125
- Pathways for Children Needs To Strengthen Documentation Requirements A-01-18-02503
- Updated Corporate Integrity Agreements
- 12-03-2019
- Medicare Hospital Provider Compliance Audit: Northwest Medical Center A-04-18-08064
- Medicare Hospital Provider Compliance Audit: Carolinas Hospital A-04-18-08063
- 12-02-2019
- Fall 2019 Semiannual Report to Congress
- OIG Fiscal Year 2019 Semiannual Report Reveals Taxpayers Could See Nearly $5.9 Billion Returned to Government
November
- 11-27-2019
- Hospitals Received Millions in Excessive Outlier Payments Because CMS Limits the Reconciliation Process A-05-16-00060
- 11-26-2019
- Noridian Healthcare Solutions, LLC, Did Not Claim Allowable Medicare Nonqualified Costs A-07-19-00574
- Noridian Healthcare Solutions, LLC, Did Not Claim Allowable Medicare Nonqualified Costs Through Its Incurred Cost Proposals A-07-19-00573
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 11-25-2019
- Cahaba Safeguard Administrators, LLC, Properly Updated the Medicare Segment Pension Assets as of January 1, 2017 A-07-19-00571
- Cahaba Government Benefits Administrators, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-19-00570
- 11-22-2019
- Highlands of Little Rock West Markham Holdings, LLC: Audit of Documentation of Therapy Resource Utilization Groups A-06-18-08003
- Updated Corporate Integrity Agreements
- 11-21-2019
- Registered Nurses Did Not Always Visit Medicare Beneficiaries' Homes At Least Once Every 14 Days To Assess The Quality of Care and Services Provided by Hospice Aides A-09-18-03022
- 11-19-2019
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2019 (OEI-03-20-00070)
- 11-18-2019
- 2019 Top Management & Performance Challenges Facing HHS
- 11-15-2019
- Updated Corporate Integrity Agreements
- Updated: Work Plan
- 11-14-2019
- Eye on Oversight - The New HHS OIG Hotline
- Statement for the Record: Office of Inspector General, U.S. Department of Health and Human Services: U.S. House Committee on Ways and Means: Caring for Aging Americans
- New Jersey Improperly Claimed Tens of Millions for Medicaid School-Based Administrative Costs Based on Random Moment Sampling That Did Not Meet Federal Requirements A-02-17-01006
- California Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-09-18-02009
- The University of Minnesota Complied With Federal Requirements To Perform Risk Assessments and Monitor Subrecipients A-05-18-00015
- 11-12-2019
- Medicare Made Hundreds of Thousands of Dollars in Overpayments for Chronic Care Management Services A-07-17-05101
- Updated Corporate Integrity Agreements
- 11-08-2019
- Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs A-07-19-00569
- Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00568
- Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Postretirement Benefit Assets A-07-19-00567
- Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-18-00550
- Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Pension Costs A-07-18-00548
- Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Pension Assets A-07-18-00547
- Updated Corporate Integrity Agreements
- 11-06-2019
- Medicare Improperly Paid Acute-Care Hospitals $54.4 Million for Inpatient Claims Subject to the Post-Acute-Care Transfer Policy A-09-19-03007
- Updated CIA Reportable Events
- Updated Provider Self-Disclosure Settlements
- 11-05-2019
- Audit of Medicare Part D Pharmacy Fees: Geisinger Health Systems, Inc. A-03-18-00006
- 11-04-2019
- LEIE Database Updated with October 2019 Exclusions and Reinstatements
- Medicare Allowable Amounts for Certain Orthotic Devices Are Not Comparable With Payments Made by Select Non-Medicare Payers A-05-17-00033
- Medicare Improperly Paid Suppliers an Estimated $92.5 Million for Inhalation Drugs A-09-18-03018
- Medicare Home Health Agency Provider Compliance Review: Angels Care Home Health A-07-16-05093
October
- 10-31-2019
- Tennessee Made Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid Identification Numbers A-04-18-07079
- Texas Did Not Ensure That Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-06-16-01001)
- 10-30-2019
- Testimony of Brian P. Ritchie, Assistant Inspector General for Audit Services, Office of Inspector General, U.S. Department of Health and Human Services: U.S. Senate Committee on Finance, Subcommittee on Health Care: Medicaid: Compliance with Eligibility Requirements
- 10-28-2019
- U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement A-17-19-54000
- Rhode Island Hospital Submitted Some Inaccurate Wage Data A-01-17-00509
- The Centers for Medicare & Medicaid Services Could Improve Its Processes for Evaluating and Reporting Payment Recovery Savings Associated With the Fraud Prevention System A-01-15-00510
- 10-25-2019
- Updated Corporate Integrity Agreements
- 10-24-2019
- Testimony of Gary Cantrell, Deputy Inspector General for Investigations, Office of Investigations, Office of Inspector General, U.S. Department of Health and Human Services: U.S. Senate Committee on Finance: OIG's Efforts to Address the Prescribing and Treatment Dimensions of the Opioid Crisis
- 10-23-2019
- Sunshine ACO, LLC, Generally Reported Complete and Accurate Data on Quality Measures Through the CMS Web Portal, but There Were a Few Reporting Deficiencies That Did Not Affect the Overall Quality Performance Score (A-09-18-03019)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 10-22-2019
- Trends in Nursing Home Complaints (2016-2018)
- 10-21-2019
- New York State Claimed Federal Reimbursement for Unallowable Childcare Subsidies Paid to New York City (A-02-17-02010)
- 10-15-2019
- Updated Fraud Risk Indicator
- Updated: Work Plan
- 10-10-2019
- LEIE Database Updated with September 2019 Exclusions and Reinstatements
- Updated CIA Reportable Events
- Updated Provider Self-Disclosure Settlements
- 10-09-2019
- Revisions to the Safe Harbors Under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements
- Wisconsin Physicians Service Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances (A-06-17-04005)
- Updated Corporate Integrity Agreements
- Updated State False Claims Act Review Letters
- 10-08-2019
- Updated Corporate Integrity Agreements
- 10-04-2019
- The Next Door Foundation Claimed Unallowable Indirect Costs and Did Not Document the Funding Source of Program Expenditures in Accordance With Federal Requirements (A-05-18-00008)
- 10-03-2019
- The Minnesota State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths (A-05-17-00049)
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 10-02-2019
- California Needs To Improve Oversight of Community-Based Adult Services Providers' Compliance With Health and Safety and Administrative Requirements (A-09-18-02002)
- 10-01-2019
- National Government Services, Inc., Did Not Claim Some Medicare Postretirement Benefit Plan Costs Through Its Incurred Cost Proposals (A-07-19-00566)
- National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals (A-07-19-00572)
- Updated Corporate Integrity Agreements
- Spring and Summer Internship Applications
- 09-30-2019
- National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals (A-07-19-00564)
- National Government Services, Inc., Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals (A-07-19-00565)
- 09-27-2019
- Nationwide Genetic Testing Fraud
- NIH Has Made Strides in Reviewing Financial Conflicts of Interest in Extramural Research, But Could Do More (OEI-03-19-00150)
- Vetting Peer Reviewers at NIH's Center for Scientific Review: Strengths and Limitations (OEI-01-19-00160)
- Patient Safety Organizations: Hospital Participation, Value, and Challenges (OEI-01-17-00420)
- The National Institutes of Health Has Limited Policies, Procedures, and Controls in Place for Helping To Ensure That Institutions Report All Sources of Research Support, Financial Interests, and Affiliations (A-03-19-03003)
- Updated Corporate Integrity Agreements
- 09-26-2019
- Department of Health and Human Services Had Email Requirements for Political Appointees, but Office of the Secretary Lacked Effective Monitoring and Enforcement (A-18-18-11050)
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2017 in Accordance With Federal Requirements (A-04-19-04071)
- National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Final Administrative Cost Proposals (A-07-19-00563)
- National Government Services, Inc., Claimed Some Unallowable Supplemental Executive Retirement Plan Costs Through Its Final Administrative Cost Proposals (A-07-18-00551)
- 09-24-2019
- CMS Paid Over $277 Million in Unallowable CHIPRA Bonus Payments Based on Incorrect Enrollment Data (A-04-17-08061)
- 09-23-2019
- Ohio Made Medicaid Capitation Payments That Were Duplicative or Were Improper Based on Beneficiary Eligibility Status or Demographics (A-05-16-00061)
- Opioid Use in Medicare Part D in Missouri (OEI-02-19-00391)
- Arrested Deadbeat: Charles Hefner
- 09-20-2019
- Reasonable Assumptions in Manufacturer Reporting of AMPs and Best Prices (OEI-12-17-00130)
- 09-19-2019
- Testimony of Ann Maxwell, Assistant Inspector General, Office of Inspector General, Office of Evaluation and Inspections, U.S. Department of Health and Human Services: U.S. House Committee on Energy & Commerce: HHS-OIG Oversight of the Unaccompanied Alien Children Program
- Some Medicare Part D Beneficiaries Face Avoidable Extra Steps That Can Delay or Prevent Access to Prescribed Drugs (OEI-09-16-00411)
- Texas Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-06-17-04001)
- 09-18-2019
- Testimony of Ann Maxwell, Assistant Inspector General, Office of Inspector General, Office of Evaluation and Inspections, U.S. Department of Health and Human Services: U.S. House Committee on Appropriations: HHS-OIG Oversight of the Unaccompanied Alien Children Program
- Medicare's Oversight of Ambulatory Surgery Centers (OEI-01-15-00400)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated CIA Reportable Events
- 09-16-2019
- Provider Shortages and Limited Availability of Behavioral Health Services in New Mexico's Medicaid Managed Care (OEI-02-17-00490)
- Medicare Incorrectly Paid Providers for Emergency Ambulance Transports From Hospitals to Skilled Nursing Facilities (A-09-18-03030)
- Updated: Work Plan
- 09-13-2019
- Rebates for Brand Name Drugs in Part D Substantially Reduced the Growth in Spending from 2011 to 2015 (OEI-03-19-00010)
- Updated Provider Self-Disclosure Settlements
- Updated Grantee Self-Disclosure Protocol
- 09-12-2019
- Vermont's Office of Child Support Needs Better Oversight Over Its Administrative Costs Claimed (A-01-18-02501)
- 09-11-2019
- Advisory Opinion 19-05 (regarding a proposed purchase of real estate from a limited liability company owned, in part, by an excluded individual)
- 09-10-2019
- The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home Health Agencies (A-05-17-00035)
- Advisory Opinion 19-04 (regarding a technology company's proposal to make visible to Federal health care program beneficiaries: (i) its online healthcare directory for searching and booking medical appointments, where healthcare professionals pay, or would pay, per-click or per-booking fees to be listed in the directory; and (ii) sponsored advertisements on its online healthcare directory and third-party websites, where healthcare professionals pay, or would pay, per-impression or per-click fees for such sponsored advertisements (the "Proposed Arrangement"))
- 09-06-2019
- LEIE Database Updated with August 2019 Exclusions and Reinstatements
- 09-05-2019
- Twin Palms Received Unallowable Medicare Payments for Chiropractic Services (A-04-16-07065)
- West Florida ACO, LLC, Generally Reported Complete and Accurate Data on Quality Measures Through the CMS Web Portal, but There Were a Few Reporting Deficiencies That Did Not Affect the Overall Quality Performance Score (A-09-18-03003)
- Oceanside Medical Group Received Unallowable Medicare Payments for Psychotherapy Services (A-09-18-03004)
- Updated Corporate Integrity Agreements
- 09-04-2019
- Care Provider Facilities Described Challenges Addressing Mental Health Needs of Children in HHS Custody (OEI-09-18-00431)
- Unaccompanied Alien Children Care Provider Facilities Generally Conducted Required Background Checks but Faced Challenges in Hiring, Screening, and Retaining Employees (A-12-19-20001)
- Featured Topics: Unaccompanied Children
- Media Materials: Unaccompanied Children
- Colorado Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries (A-07-16-04228)
- Florida Medicaid Paid Hundreds of Millions in Unallowable Payments to Jackson Memorial Hospital Under Its Low Income Pool Program (A-04-17-04058)
- 09-03-2019
- New Jersey Did Not Bill Manufacturers for Tens of Millions of Dollars in Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-02-16-01011)
- Illinois Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries' Deaths (A-05-18-00026)
- 08-29-2019
- Organizational Challenges to Improving Quality of Care in Indian Health Service Hospitals (OEI-06-16-00390)
- Mederi Caretenders Home Health Billed for Home Health Services That Did Not Comply With Medicare Billing Requirements (A-07-16-05092)
- 08-28-2019
- Utah Medicaid Fraud Control Unit: 2018 Onsite Review (OEI-09-18-00170)
- All Six States Reviewed Had Partially Implemented New Criminal Background Check Requirements for Childcare Providers, and Five of the States Anticipate Full Implementation by Fiscal Year 2020 (A-05-19-00015)
- 08-27-2019
- Medicare Part D Is Still Paying Millions for Drugs Already Paid for Under the Part A Hospice Benefit (A-06-17-08004)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 08-26-2019
- National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded in 2017 and 2018 (OEI-07-18-00290)
- 08-23-2019
- New York Incorrectly Claimed Enhanced Federal Medicaid Reimbursement for Some Beneficiaries (A-02-15-01023)
- New York Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness (A-02-17-01027)
- The Administration for Children and Families Should Improve the Oversight of Tribal Grantees' Low-Income Home Energy Assistance Programs (A-07-17-04105)
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2018 (A-18-19-11300)
- 08-22-2019
- Idaho Medicaid Fraud Control Unit: 2018 Onsite Inspection (OEI-12-18-00320)
- The Food and Drug Administration Did Not Submit Clearance Documents for Any Audit Recommendations During Fiscal Years 2015 and 2016 but Has Since Made Significant Progress (A-07-18-03231)
- 08-20-2019
- National Review of Opioid Prescribing in Medicaid Is Not Yet Possible (OEI-05-18-00480)
- Southwest Key Did Not Have Adequate Controls in Place To Secure Personally Identifiable Information Under the Unaccompanied Alien Children Program (A-18-18-06001)
- Southwest Key Programs Did Not Always Comply With Health and Safety Requirements For The Unaccompanied Alien Children Program (A-06-17-07005)
- Connecticut Claimed Unallowable Federal Reimbursement for Medicaid Physician-Administered Drugs That Were Not Invoiced to Manufacturers for Rebates (A-07-18-06078)
- The Health Resources and Services Administration Resolved All of Its Audit Recommendations, With Over 99 Percent Resolved in Accordance With Federal Timeliness Requirements (A-07-19-03235)
- 08-19-2019
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2017 Average Sales Prices (OEI-03-19-00260)
- 08-16-2019
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 08-15-2019
- Updated: Work Plan
- Many Medicaid-Enrolled Children Who Were Treated for ADHD Did Not Receive Recommended Followup Care (OEI-07-17-00170)
- HHS Did Not Always Efficiently Plan and Coordinate Its International Ebola Response Efforts (A-04-16-03567)
- Pennsylvania Did Not Ensure That Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-03-16-00205)
- 08-14-2019
- The Administration for Community Living Failed To Conduct Any of the Required Onsite Compliance Reviews of Independent Living Programs (A-05-18-00034)
- 08-13-2019
- States' Payment Rates Under the Child Care and Development Fund Program Could Limit Access to Child Care Providers (OEI-03-15-00170)
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2019 (OEI-03-19-00050)
- Georgia Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries' Deaths (A-04-15-06183)
- New York Achieved Program Goals For Enhancing Its Prescription Drug Monitoring Program (A-02-18-02001)
- 08-09-2019
- Updated Corporate Integrity Agreements
- Updated Provider Self-Disclosure Settlements
- 08-08-2019
- LEIE Database Updated with July 2019 Exclusions and Reinstatements
- 08-06-2019
- Updated Corporate Integrity Agreements
- 07-31-2019
- Group Health Incorporated Understated Its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets as of January 1, 2015 (A-07-19-00561)
- Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Pension Assets as of January 1, 2015 (A-07-19-00562)
- Group Health Incorporated Understated Its Cash Balance Pension Plan Medicare Segment Pension Assets as of January 1, 2011 (A-07-19-00557)
- 07-30-2019
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 07-29-2019
- Updated Corporate Integrity Agreements
- Updated Stipulated Penalties and Exclusion for Material Breach
- 07-26-2019
- Oversight of Opioid Prescribing and Monitoring of Opioid Use: States Have Taken Action To Address the Opioid Epidemic (A-09-18-01005)
- Kansas Medicaid Fraud Control Unit: 2018 Onsite Inspection (OEI-12-18-00210)
- 07-24-2019
- The Substance Abuse and Mental Health Services Administration Resolved Approximately One-Third of Its Audit Recommendations, None in Accordance With Federal Timeframe Requirements (A-07-19-03233)
- ACOs' Strategies for Transitioning to Value-Based Care: Lessons From the Medicare Shared Savings Program (OEI-02-15-00451)
- 07-23-2019
- Testimony of Megan H. Tinker, Senior Advisor for Legal Affairs, Office of Counsel to the Inspector General, Office of Inspector General, U.S. Department of Health and Human Services: United States Senate Committee on Finance: Promoting Elder Justice: A Call for Reform
- A Resource Guide for Using Diagnosis Codes in Health Insurance Claims To Help Identify Unreported Abuse or Neglect (A-01-19-00502)
- 07-22-2019
- Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG's Top Recommendations
- Case Study: Indian Health Service Management of Rosebud Hospital Emergency Department Closure and Reopening (OEI-06-17-00270)
- IHS Needs To Improve Oversight of Its Hospitals' Opioid Prescribing and Dispensing Practices and Consider Centralizing Its Information Technology Functions (A-18-17-11400)
- New York Did Not Correctly Determine Medicaid Eligibility for Some Non-Newly Eligible Beneficiaries (A-02-16-01005)
- 07-19-2019
- Updated Corporate Integrity Agreements
- 07-16-2019
- 99 of 100 California Department of Social Services Refugee Cash Assistance Payments Received Were Allowable (A-04-18-02017)
- Kentucky Did Not Comply With Federal Waiver and State Requirements at 14 of 20 Adult Day Health Care Facilities Reviewed (A-04-18-00123)
- Updated Corporate Integrity Agreements
- 07-15-2019
- Problems Remain for Ensuring That All High Risk Medicaid Providers Undergo Criminal Background Checks (OEI-05-18-00070)
- Eye on Oversight: Medicaid Provider Enrollment Screening
- Updated: Work Plan
- 07-12-2019
- Testimony of Ann Maxwell, Assistant Inspector General, Office of Inspector General, Office of Evaluation and Inspections, Office of Inspector General, U.S. Department of Health and Human Services: U.S. House Committee on Oversight and Reform: HHS-OIG Oversight of the Unaccompanied Alien Children Program
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 07-11-2019
- Updated Corporate Integrity Agreements
- HHS OIG Grant Self-Disclosure Program Guidance
- Updated Grantee Self-Disclosure Protocol
- 07-10-2019
- LEIE Database Updated with June 2019 Exclusions and Reinstatements
- Opioid Use Decreased in Medicare Part D, While Medication-Assisted Treatment Increased (OEI-02-19-00390)
- New York's Claims for Medicaid Nursing Home Transition and Diversion Waiver Program Services Generally Complied With Federal and State Requirements but Had Reimbursement Errors That Resulted in a Minimal Amount of Overpayments (A-02-17-01005)
- New York Claimed Federal Reimbursement for Some Payments to Health Home Providers That Did Not Meet Medicaid Requirements (A-02-17-01004)
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated Corporate Integrity Agreements
- 07-09-2019
- Hospice Deficiencies Pose Risks to Medicare Beneficiaries (OEI-02-17-00020)
- Safeguards Must Be Strengthened To Protect Medicare Hospice Beneficiaries From Harm (OEI-02-17-00021)
- 2019: Vulnerabilities in Hospice Care
- 07-05-2019
- Medicare Part D Rebates for Prescriptions Filled at 340B Contract Pharmacies (A-03-16-00002)
- Updated Fraud Risk Indicator
- 07-03-2019
- Updated Provider Self-Disclosure Settlements
- 07-02-2019
- Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2019 (OEI-05-19-00220)
- The Food and Drug Administration Generally Complied With Federal Requirements for the Preparation and Receipt of Select Agent Shipments (A-03-16-00354)
- Recommendation Followup: Delaware Is Reporting Medicaid Overpayments In Compliance With Federal Requirements (A-03-17-00203)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 07-01-2019
- The Florida Department of Children and Families Made Some Unallowable Refugee Cash Assistance Payments (A-04-18-02011)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 06-28-2019
- Illinois Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-18-00030)
- Updated Corporate Integrity Agreements
- 06-21-2019
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2016 in Accordance With Federal Requirements (A-04-18-04065)
- Updated Corporate Integrity Agreements
- 06-20-2019
- Updated Corporate Integrity Agreements
- 06-19-2019
- Testimony of Vicki L. Robinson, Senior Counselor for Policy, Office of Inspector General, U.S. Department of Health and Human Services: U.S. Senate Special Committee on Aging: The Complex Web of Prescription Drug Prices, Part III: Examining Agency Efforts to Further Competition and Increase Affordability
- Medicare Could Have Saved Millions of Dollars in Payments for Three-Dimensional Conformal Radiation Therapy Planning Services (A-09-18-03026)
- 06-18-2019
- Updated Corporate Integrity Agreements
- 06-17-2019
- Updated: Work Plan
- Princeton Place Did Not Always Comply With Care Plans for Residents Who Were Diagnosed With Urinary Tract Infections (A-06-17-02002)
- The Therapy Resource Utilization Groups at Epworth Villa Retirement Community's Skilled Nursing Facility Were Properly Supported (A-06-18-08002)
- 06-14-2019
- The National Institutes of Health Could Improve Its Monitoring To Ensure That an Awardee of the All of Us Research Program Had Adequate Cybersecurity Controls To Protect Participants' Sensitive Data Audit (A-18-17-09304)
- Updated Corporate Integrity Agreement List
- Job Opening: Medicare/Medicaid Attorney Deadline to Apply: June 28, 2019
- 06-13-2019
- Alaska Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities (A-09-17-02006)
- 06-12-2019
- Video: Eye on Oversight: Abuse & Neglect of Medicare Beneficiaries
- Media Materials: Abuse and Neglect of Medicare Beneficiaries
- CMS Could Use Medicare Data To Identify Instances of Potential Abuse or Neglect (A-01-17-00513)
- Incidents of Potential Abuse and Neglect at Skilled Nursing Facilities Were Not Always Reported and Investigated (A-01-16-00509)
- Medicare Payments to Providers for Polysomnography Services Did Not Always Meet Medicare Billing Requirements (A-04-17-07069)
- Most Hospitals Obtain Compounded Drugs From Outsourcing Facilities, Which Must Meet FDA Quality Standards (OEI-01-17-00090)
- 06-11-2019
- New York May Not Have Complied With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-02-16-01022)
- The University of Kentucky Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program (A-04-18-02012)
- Updated Provider Self-Disclosure Settlements
- 06-07-2019
- Nevada Medicaid Fraud Control Unit: 2018 Onsite Inspection (OEI-06-18-00190)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 06-06-2019
- Great Lakes Home Health Services, Inc., Billed for Home Health Services That Did Not Comply With Medicare Coverage and Payment Requirements (A-05-16-00057)
- 06-05-2019
- Testimony of Leslie W. Hollie, Chief of Investigative Operations, Office of Inspector General, U.S. Department of Health and Human Services: U.S. Senate Committee on Finance: Foreign Threats to Taxpayer-Funded Medical Research: Oversight Opportunities and Policy Solutions
- Job Openings: Experienced Health Care Attorneys (Associate and Senior Counsel Positions) Deadline to Apply: July 12, 2019
- St. Joseph's Hospital and Medical Center Submitted Some Inaccurate Wage Data (A-01-17-00510)
- LEIE Database Updated with May 2019 Exclusions and Reinstatements
- 06-03-2019
- Fraud Alert: Genetic Testing Scam
- Spring Semiannual Report to Congress
- 05-31-2019
- FY18 Health Care Fraud and Abuse Control (HCFAC) Program
- 05-29-2019
- 2018 Performance Data for the Senior Medicare Patrol Projects (OEI-02-19-00280)
- 05-24-2019
- Metropolitan Jewish Home Care, Inc., Billed for Home Health Services That Did Not Comply with Medicare Requirements (A-02-16-01001)
- Massachusetts Did Not Ensure Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-01-17-00003)
- Excella HomeCare Billed for Home Health Services That Did Not Comply With Medicare Coverage and Payment Requirements (A-01-16-00500)
- 05-23-2019
- EHS Home Health Care Service, Inc., Billed for Home Health Services That Did Not Comply With Medicare Coverage and Payment Requirements (A-05-16-00055)
- New Jersey Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-02-16-01012)
- 05-22-2019
- Using Health IT for Care Coordination: Insights from Six Medicare Accountable Care Organizations (OEI-01-16-00180)
- 05-21-2019
- Four States Did Not Comply With Federal Waiver and State Requirements in Overseeing Adult Day Care Centers and Foster Care Homes (A-05-19-00005)
- 05-15-2019
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2018 (OEI-03-19-00040)
- Video: Joanne Chiedi's Remarks at the 2019 HCCA Compliance Institute
- Updated: Work Plan
- 05-13-2019
- U.S. Department of Health and Human Services Met Many Requirements of the Improper Payments Information Act of 2002 but Did Not Fully Comply for Fiscal Year 2018 (A-17-19-52000)
- 05-10-2019
- California Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries� Deaths (A-04-18-06220)
- Updated Corporate Integrity Agreement List
- 05-09-2019
- LEIE Database Updated with April 2019 Exclusions and Reinstatements
- 05-07-2019
- Updated Corporate Integrity Agreement List
- 05-06-2019
- One Percent of Drugs With Medicaid Reimbursement Were Not FDA-Approved (OEI-03-17-00120)
- Updated Provider Self-Disclosure Settlements
- 05-03-2019
- Medicaid Could Save Hundreds of Millions by Excluding Authorized Generic Drug Transactions to Secondary Manufacturers from Brand Name Drugs� Average Manufacturer Price Calculations (A-06-18-04002)
- 05-02-2019
- Some Diagnosis Codes That Essence Healthcare, Inc., Submitted to CMS Did Not Comply With Federal Requirements (A-07-17-01170)
- Trends in Deficiencies at Nursing Homes Show That Improvements Are Needed To Ensure the Health and Safety of Residents (A-09-18-02010)
- Updated Corporate Integrity Agreement List
- 05-01-2019
- The Children's Village, Inc., an Administration for Children and Families Grantee, Did Not Always Comply with Applicable Federal and State Policies and Requirements (A-02-16-02013)
- 04-30-2019
- The Centers for Disease Control and Prevention's South Africa Office Generally Implemented Our Prior Audit Recommendation (A-04-18-01009)
- 04-26-2019
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 04-25-2019
- National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded Between 2013 and 2016 (OEI-07-16-00160)
- Updated Corporate Integrity Agreement List
- 04-19-2019
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2018 (A-18-18-11200)
- 04-18-2019
- Washington State Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program (A-09-18-01001)
- 04-17-2019
- Concerns About Opioid Use in Medicare Part D in the Appalachian Region (OEI-02-18-00224)
- 2019 Appalachian Region Opioid Takedown
- 04-15-2019
- Updated: Work Plan
- 04-11-2019
- Factsheet: Texas' Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-06-18-04000)
- Indiana Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-17-00038)
- Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria—Fiscal Year 2019 Inspectors General Coordinated Oversight Plan
- 04-10-2019
- LEIE Database Updated with March 2019 Exclusions and Reinstatements
- 04-09-2019
- Fraud Alert: Nationwide Brace Scam
- Media Materials: Nationwide Brace Scam
- 04-08-2019
- The Passamaquoddy Tribe's Pleasant Point Health Center Needs To Improve Its Medical-Referral Process (A-01-17-01503)
- Updated Fraud Risk Indicator
- Updated Stipulated Penalties and Exclusion for Material Breach
- 04-05-2019
- Although the Administration for Community Living Resolved Nearly All Audit Recommendations, It Did Not Always Do So in Accordance With Federal Timeframe Requirements (A-07-18-03232)
- 04-04-2019
- Updated Corporate Integrity Agreement List
- Updated Provider Self-Disclosure Settlements
- Grantee Self-Disclosure Settlements
- 04-02-2019
- The Substance Abuse and Mental Health Services Administration Followed Grant Regulations and Program-Specific Requirements When Awarding State Targeted Response to the Opioid Crisis Grants (A-03-17-03302)
- 03-28-2019
- New Jersey Did Not Provide Adequate Oversight of Its Medicaid Delivery System Reform Incentive Payment Program (A-02-17-01007)
- 03-27-2019
- New York Did Not Provide Adequate Stewardship of Substance Abuse Prevention and Treatment Block Grant Funds (A-02-17-02009)
- Weill Cornell Medicine Monitored Subrecipients and Claimed Allowable National Institutes of Health Award Costs (A-02-17-02006)
- 03-25-2019
- Medicaid Fraud Control Units Fiscal Year 2018 Annual Report (OEI-09-19-00230)
- Medicare Market Shares of Non-Mail Order Diabetes Test Strips From April Through June 2018 (OEI-04-18-00441)
- Recommendation Followup: Vulnerabilities Continue To Exist in the HHS Small Business Innovation Research Program (OEI-04-18-00230)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 03-22-2019
- Final Rule: Revisions to State Medicaid Fraud Control Unit Rules
- 03-20-2019
- Updated Corporate Integrity Agreement List
- 03-19-2019
- Updated Stipulated Penalties and Exclusion for Material Breach
- 03-18-2019
- FY 2020 Congressional Budget Justification
- 03-15-2019
- Updated: Work Plan
- 03-13-2019
- Summary Report for Office of Inspector General Penetration Testing of Eight HHS Operating Division Networks (A-18-18-08500)
- 03-12-2019
- Factsheet: West Virginia's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-03-18-03302)
- Michigan Disbursed Only Part of Its Civil Money Penalty Collections, Limiting Resources To Protect or Improve Care for Nursing Facility Residents (A-05-17-00019)
- 03-11-2019
- LEIE Database Updated with February 2019 Exclusions and Reinstatements
- Updated Corporate Integrity Agreement List
- 03-08-2019
- Missouri Claimed Some Unallowable Medicaid Payments for Targeted Case Management Services (A-07-17-03219)
- New Mexico Did Not Always Appropriately Refund the Federal Share of Recoveries from Managed Care Organizations (A-06-18-09001)
- Updated Provider Self-Disclosure Settlements
- 03-07-2019
- Advisory Opinion 19-03 (regarding a program offered by a medical center that provides free, in-home follow-up care to eligible individuals with congestive heart failure (the "Current Arrangement") and the proposed expansion of this program to include certain individuals with chronic obstructive pulmonary disease)
- 03-01-2019
- Factsheet: New Hampshire's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-01-18-01501)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 02-28-2019
- Although the Centers for Disease Control and Prevention Resolved Nearly All Audit Recommendations, It Did Not Always Do So in Accordance With Federal Timeframe Requirements (A-07-17-03226)
- 02-21-2019
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 02-20-2019
- CMS Improperly Paid Millions of Dollars for Skilled Nursing Facility Services When the Medicare 3-Day Inpatient Hospital Stay Requirement Was Not Met (A-05-16-00043)
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2018 (OEI-03-19-00030)
- Updated Corporate Integrity Agreement List
- 02-19-2019
- Factsheet: Nevada's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-09-18-01004)
- TrustSolutions, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals (A-07-18-00540)
- CDC Reimbursed Contractors for Some Unallowable World Trade Center Health Program Administrative Costs (A-02-16-02012)
- Updated Corporate Integrity Agreement List
- 02-15-2019
- Updated: Work Plan
- Job Opening: Health Information Technology Attorney (Term Appointment), Deadline: March 13, 2019
- 02-14-2019
- Lincoln Hall Boys' Haven, an Administration for Children and Families Grantee, Did Not Always Comply With Applicable Federal and State Policies and Requirements (A-02-16-02007)
- 02-13-2019
- Most Wanted Fugitive Juan Gil Alejo Sentenced to Prison
- Opportunities Exist for the National Institutes of Health To Strengthen Controls in Place To Permit and Monitor Access to Its Sensitive Data (A-18-18-09350)
- Factsheet: Utah's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-07-18-05115)
- Factsheet: Tennessee's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-04-18-00124)
- Medicare Compliance Review of Community Hospital (A-05-17-00026)
- 02-11-2019
- CMS Guidance to State Survey Agencies on Verifying Correction of Deficiencies Needs To Be Improved To Help Ensure the Health and Safety of Nursing Home Residents (A-09-18-02000)
- Medicare Paid Twice for Ambulance Services Subject to Skilled Nursing Facility Consolidated Billing Requirements (A-01-17-00506)
- 02-07-2019
- Testimony of Ann Maxwell, Assistant Inspector General for Evaluation and Inspections, Office of Inspector General, U.S. Department of Health and Human Services: U.S. House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations: Examining the Failures of the Trump Administration's Inhumane Family Separation Policy
- Factsheet: Nebraska's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-07-18-06080)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated Provider Self-Disclosure Settlements
- 02-06-2019
- Updated Corporate Integrity Agreement List
- 02-05-2019
- LEIE Database Updated with January 2019 Exclusions and Reinstatements
- Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings (A-04-18-06225)
- Updated State False Claims Act Review Letters
- 02-01-2019
- Updated Fraud Risk Indicator
- 01-29-2019
- Advisory Opinion 19-02 (regarding a pharmaceutical manufacturer's proposal to loan, on a temporary basis, a limited- functionality smartphone to financially needy patients who do not have the technology necessary to receive adherence data from a sensor embedded in prescribed antipsychotic medication)
- 01-25-2019
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 01-24-2019
- Updated Corporate Integrity Agreement List
- 01-22-2019
- Kelley Medical Equipment and Supply, LLC, Received Unallowable Medicare Payments for Orthotic Braces (A-09-17-03030)
- 01-18-2019
- Although the Centers for Medicare & Medicaid Services Has Made Progress, It Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements (A-07-18-03228)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 01-17-2019
- Separated Children Placed in Office of Refugee Resettlement Care (OEI-BL-18-00511)
- Featured Topic: Unacommpanied Children
- Media Materials: Unaccompanied Children
- News Release: HHS OIG: Many Children Separated from Parents, Guardians Before Ms. L. v. Ice Court Order and Some Separations Continue
- 01-16-2019
- Updated: Work Plan
- Updated Corporate Integrity Agreement List
- 01-15-2019
- Updated Corporate Integrity Agreement List
- 01-14-2019
- Advisory Opinion 19-01 (regarding a charitable pediatric clinic's arrangement under which the clinic waives cost-sharing amounts in certain circumstances)
- Virginia Received Millions in Unallowable Bonus Payments (A-04-17-08060)
- Rhode Island Did Not Ensure Its Managed Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-01-17-00004)
- New York Has Not Fully Implemented New Criminal Background Check Requirements for Childcare Providers (A-02-17-02011)
- 01-11-2019
- UPDATED: The Tornillo Influx Care Facility: Concerns About Staff Background Checks and Number of Clinicians on Staff
- 01-10-2019
- LEIE Database Updated with December 2018 Exclusions and Reinstatements
- Medicare Market Shares of Mail Order Diabetes Test Strips From April Through June 2018 (OEI-04-18-00440)
- 01-09-2019
- Pathways for Children Generally Complied With Health and Safety Requirements (A-01-18-02502)
- 01-08-2019
- Updated Provider Self-Disclosure Settlements
- 01-07-2019
- Most Wanted Fugitive: Betros Garabet
- A Queens Chiropractor Received Improper Medicare Payments for Chiropractic Services (A-02-15-01003)
- Updated Corporate Integrity Agreement List
- 01-03-2019
- Pacific Medical, Inc., Received Some Unallowable Medicare Payments for Orthotic Braces (A-09-17-03027)
- Dialysis Services Provided by Atlantis Health Care Group of Puerto Rico, Inc., Did Not Comply With Medicare Requirements Intended To Ensure the Quality of Care Provided to Medicare Beneficiaries (A-02-16-01009)
September
August
July
June
May
April
March
February
January
-
December
- 12-27-2018
- First Coast Service Options, Inc., Paid Providers for Hyperbaric Oxygen Therapy Services That Did Not Comply With Medicare Requirements (A-04-16-06196)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 12-21-2018
- Midwood Ambulance & Oxygen Service, Inc., Billed for Nonemergency Ambulance Transport Services That Did Not Comply With Medicare Requirements (A-02-16-01021)
- Louisiana Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-06-16-02003)
- 12-20-2018
- The Administration for Children and Families Has Controls and Strategies To Mitigate Hurricane Preparedness and Response Risk (A-04-18-02013)
- Wisconsin Did Not Report and Refund the Full Federal Share of Medicaid-Related Settlements and a Judgment (A-05-17-00041)
- The Health Resources and Services Administration Has Controls and Strategies To Mitigate Hurricane Preparedness and Response Risk (A-04-18-02015)
- 12-19-2018
- Updated Corporate Integrity Agreement List
- 12-17-2018
- Eye on Oversight: 2018 Year in Review
- Updated: Work Plan
- Factsheet: Washington State's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-09-18-02001)
- Texas Claimed Community First Choice Fee-for-Service Expenditures Appropriately (A-06-17-08002)
- Payments Made by National Government Services, Inc., to Hospitals for Certain Advanced Radiation Therapy Services Did Not Fully Comply With Medicare Requirements (A-02-16-01007)
- 12-13-2018
- California Made Medicaid Payments on Behalf of Non-Newly Eligible Beneficiaries Who Did Not Meet Federal and State Requirements (A-09-17-02002)
- 12-12-2018
- The National Institutes of Health Generally Complied With Federal Requirements for the Preparation and Receipt of Select Agent Shipments (A-03-15-00354)
- 12-11-2018
- BCFS Health and Human Services Did Not Always Comply With Federal and State Requirements Related to the Health and Safety of Unaccompanied Alien Children (A-06-17-07007)
- Vulnerabilities Exist in State Agencies' Use of Random Moment Sampling To Allocate Costs for Medicaid School-Based Administrative and Health Services Expenditures (A-07-18-04107)
- The Centers for Medicare & Medicaid Services Had Not Recovered More Than a Billion Dollars in Medicaid Overpayments Identified by OIG Audits (A-05-17-00013)
- 12-10-2018
- OIG Most Wanted Fugitive: Ashot Sanamian
- LEIE Database Updated with November 2018 Exclusions and Reinstatements
- Job Opening: Affirmative Litigation Attorney
- 12-06-2018
- The Penobscot Indian Nation Did Not Meet All Federal and Tribal Health and Safety Requirements (A-01-17-01502)
- Updated Corporate Integrity Agreement List
- Updated Provider Self-Disclosure Settlements
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 12-04-2018
- Adverse Events in Long-Term-Care Hospitals: National Incidence Among Medicare Beneficiaries (OEI-06-14-00530)
- Podcast: Adverse Events in Long-Term-Care Hospitals
- Medicare Improperly Paid Suppliers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Beneficiaries During Inpatient Stays (A-09-17-03035)
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2017 (A-18-18-11300)
- Corporación Salud Asegurada por Nuestra Organización Solidaria, Inc., a Health Resources and Services Administration Grantee, Generally Complied With Federal Grant Requirements (A-02-17-02004)
November
- 11-30-2018
- Fall 2018 Semiannual Report to Congress
- HHS OIG: A Good Investment
- CMS's Enhanced Controls Did Not Always Prevent Terminated Drug Utilization in Medicare Part D (A-07-16-06068)
- New York May Have Improperly Claimed Medicaid Reimbursement for Certain Dental Services (A-02-16-01020)
- 11-28-2018
- Updated Corporate Integrity Agreement List
- 11-27-2018
- The Tornillo Influx Care Facility: Concerns About Staff Background Checks and Number of Clinicians on Staff (A-12-19-20000)
- Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Payments (A-01-17-00500)
- Summary of Security Vulnerabilities Identified at Two Arizona Managed Care Organizations and Inconsistent Treatment of Medicaid Data Security at the State Agency and Managed Care Organizations (A-18-17-09302)
- 11-26-2018
- Northwestern University Did Not Always Comply With Federal Requirements To Perform Risk Assessments of Subrecipients, but Claimed Allowable Costs (A-05-17-00016)
- Updated Corporate Integrity Agreement List
- 11-20-2018
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2018 (OEI-03-19-00020)
- 11-16-2018
- 2018 Top Management and Performance Challenges
- Advisory Opinion 18-14 (regarding a drug company's proposal to provide free product to hospitals for the hospitals to use exclusively to treat inpatients who have been diagnosed with one particular condition)
- 11-15-2018
- Updated: Work Plan
- National Government Services, Inc., Understated Its Plan A Medicare Segment Pension Assets (A-07-18-00541)
- National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs (A-07-18-00543)
- National Government Services, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs (A-07-18-00552)
- 11-14-2018
- Payments Made by Novitas Solutions, Inc., to Hospitals for Certain Advanced Radiation Therapy Services Did Not Fully Comply With Medicare Requirements (A-02-16-01006)
- Although Hospital Tax Programs in Seven States Complied With Hold-Harmless Requirements, the Tax Burden on Hospitals Was Significantly Mitigated (A-03-16-00202)
- 11-13-2018
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 11-09-2018
- LEIE Database Updated with October 2018 Exclusions and Reinstatements
- The Centers for Disease Control and Prevention Has Controls and Strategies To Mitigate Hurricane Preparedness and Response Risk (A-04-18-02014)
- Updated: Provider Self-Disclosure Settlements
- 11-08-2018
- Updated Corporate Integrity Agreement List
- 11-07-2018
- Wanted: Oscar Larach-Zablah
- 11-06-2018
- Advisory Opinion 18-13 (regarding proposed donations from a charitable trust and an individual donor to a medical research institute)
- Updated Corporate Integrity Agreement List
- Providers added to High Risk - Heightened Scrutiny list
- 11-05-2018
- The Centers for Disease Control and Prevention's Namibia Office Implemented Our Prior Audit Recommendations (A-04-18-01008)
- CMS Did Not Always Ensure Hospitals Complied With Medicare Reimbursement Requirements for Graduate Medical Education (A-02-17-01017)
- New York Claimed Federal Reimbursement for Some Assertive Community Treatment Services That Did Not Meet Medicaid Requirements (A-02-17-01008)
- 11-01-2018
- The Food and Drug Administration's Policies and Procedures Should Better Address Postmarket Cybersecurity Risk to Medical Devices (A-18-16-30530)
October
- 10-31-2018
- Pennsylvania Generally Complied With Maternal, Infant, and Early Childhood Home Visiting Program Requirements (A-03-15-03300)
- Updated Stipulated Penalties and Exclusion for Material Breach
- 10-29-2018
- Advisory Opinion 18-12 regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay (the "Proposed Arrangement")
- U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Key Areas That Require Improvement (A-17-18-54000)
- Professional Clinical Laboratory, Inc., Generally Did Not Comply With Medicare Requirements For Billing Phlebotomy Travel Allowances (A-06-16-02002)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 10-26-2018
- Updated Corporate Integrity Agreement List
- 10-25-2018
- Justice Department's Criminal Division Creates Appalachian Regional Prescription Opioid Strike Force to Focus on Illegal Opioid Prescriptions
- Wisconsin Did not Comply With Federal Waiver and State Requirements at all 20 Adult Day Care Centers Reviewed (A-05-17-00030)
- 10-24-2018
- Medicare Compliance Review of Mobile Infirmary Medical Center (A-04-17-08057)
- 10-19-2018
- United Government Services, LLC, Properly Updated the Medicare Segment Pension Assets as of January 1, 2015 (A-07-18-00538)
- TrustSolutions, LLC, Properly Updated the Medicare Segment Pension Assets as of December 31, 2012 (A-07-18-00539)
- National Government Services, Inc., Properly Updated the Plan B Medicare Segment Pension Assets as of January 1, 2015 (A-07-18-00542)
- Hospitals Reported Improved Preparedness for Emerging Infectious Diseases After the Ebola Outbreak (OEI-06-15-00230)
- 10-18-2018
- Advisory Opinion 18-11 (regarding a health plan's proposal to pay its contracted providers and clinics to increase the amount of Early and Periodic Screening, Diagnostic, and Treatment services that they provide to the health plan's enrolled Medicaid beneficiaries)
- States Follow a Common Framework in Responding to Breaches of Medicaid Data (OEI-09-16-00210)
- 10-17-2018
- Florence Crittenton Services of Orange County, Inc., Did Not Always Claim Expenditures in Accordance With Federal Requirements (A-09-17-01002)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 10-16-2018
- Ohio Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries' Deaths
- 10-15-2018
- Updated: Work Plan
- Updated Corporate Integrity Agreement List
- 10-11-2018
- LEIE Database Updated with September 2018 Exclusions and Reinstatements
- 10-10-2018
- Updated: Provider Self-Disclosure Settlements and CIA Reportable Events
- 10-09-2018
- Protecting Against Cybersecurity Threats
- 10-04-2018
- Wisconsin Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries� Deaths (A-05-17-00006)
- Updated Corporate Integrity Agreement List
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 10-02-2018
- Many Inpatient Rehabilitation Facility Stays Did Not Meet Medicare Coverage and Documentation Requirements (A-01-15-00500)
- Updated Corporate Integrity Agreement List
- 10-01-2018
- Most Wanted Deadbeat: David Adams owes over $4.2 million in child support
- 09-28-2018
- Heartland Human Care Services, Inc., Generally Met Safety Standards, but Claimed Unallowable Rental Costs (A-05-16-00038)
- 09-27-2018
- Fraud Risk Indicator
- Medicare Advantage Appeal Outcomes and Audit Findings Raise Concerns About Service and Payment Denials (OEI-09-16-00410)
- Updated Corporate Integrity Agreement List
- 09-26-2018
- The Indian Health Service Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements (A-07-17-03227)
- Nevada Implemented Some New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-09-17-01003)
- Etheredge Chiropractic Received Unallowable Medicare Payments for Chiropractic Services (A-04-16-07064)
- 09-25-2018
- Eye on Oversight: Emergency Response
- Statistical Sampling: A Toolkit for MFCUs
- New Hampshire Medicaid Fraud Control Unit: 2017 Onsite Review (OEI-09-17-00200)
- New York Medicaid Fraud Control Unit: 2017 Onsite Inspection (OEI-12-17-00340)
- New Jersey Medicaid Fraud Control Unit: 2017 Onsite Review (OEI-06-17-00520)
- 09-24-2018
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 09-21-2018
- Colorado Implemented Many New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-07-17-06076)
- 09-20-2018
- Medicare Payments for Clinical Diagnostic Laboratory Tests in 2017: Year 4 of Baseline Data (OEI-09-18-00410)
- First Coast Service Options, Inc., Overstated Medicare�s Share of the Medicare Segment Excess Pension Liabilities (A-07-18-00535)
- 09-18-2018
- CMS Enrollment System Needs To Enhance Resiliency (A-18-17-06501)
- 09-17-2018
- Treatment Planning and Medication Monitoring Were Lacking for Children in Foster Care Receiving Psychotropic Medication (OEI-07-15-00380)
- Advisory Opinion 18-10 (regarding a surgical device and wound care product manufacturer's proposal to offer hospital customers a warranty program covering a suite of three products)
- Updated: Work Plan
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 09-12-2018
- National Institute of Transplantation, an Independent Histocompatibility Laboratory, Did Not Fully Comply With Medicare�s Cost-Reporting Requirements (A-09-16-02010)
- Updated Corporate Integrity Agreement List
- 09-11-2018
- FDA Should Further Integrate Its Review of Cybersecurity Into the Premarket Review Process for Medical Devices (OEI-09-16-00220)
- 09-10-2018
- LEIE Database Updated with August 2018 Exclusions and Reinstatements
- Updated Corporate Integrity Agreement List
- 09-07-2018
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 09-06-2018
- Testimony of Ruth Ann Dorrill, Regional Inspector General, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations: Examining Federal Efforts to Ensure Quality of Care and Resident Safety in Nursing Homes
- 09-05-2018
- Job Opening: Health Care Attorney Application Deadline: October 12
- The Fort Peck Assiniboine and Sioux Tribes Improperly Administered Some Low-Income Home Energy Assistance Program Funds for Fiscal Years 2011 Through 2015 (A-07-18-04106)
- Updated Provider Self-Disclosure Settlements
- 09-04-2018
- Job Opening: Affirmative Litigation Attorney Application Deadline: September 18, 2018
- 08-29-2018
- Updated Corporate Integrity Agreement List
- David Kim Added to Top 10 Most Wanted Fugitives List
- 8-28-2018
- STAT Op-Ed by Joanne M. Chiedi
Fraud, waste, and abuse in the Medicare hospice program is 'repellent' - 08-23-2018
- OIG Excludes Company and Owner from Federal Health Care Programs
- Mississippi Did Not Comply With Federal Waiver and State Requirements at All 20 Adult Day Care Facilities Reviewed (A-04-17-00116)
- Updated Corporate Integrity Agreement List
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 08-22-2018
- Updated Corporate Integrity Agreement List
- 08-21-2018
- Liberty Medical, LLC, Received Unallowable Medicare Payments for Inhalation Drugs (A-09-17-03019)
- Virginia Did Not Claim Some Medicaid Administrative Costs for Its Medallion 3.0 Waiver Program In Accordance With Federal Requirements (A-03-17-00200)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- Advisory Opinion 18-09 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay)
- 08-20-2018
- Medicare Improperly Paid Hospitals Millions of Dollars for Intensity-Modulated Radiation Therapy Planning Services (A-09-16-02033)
- Medicare Made Improper and Potentially Improper Payments for Emergency Ambulance Transports to Destinations Other Than Hospitals or Skilled Nursing Facilities (A-09-17-03017)
- Updated Corporate Integrity Agreement List
- 08-16-2018
- The Passamaquoddy Tribe's Pleasant Point Health Center Did Not Always Meet Federal and Tribal Health and Safety Requirements (A-01-17-01500)
- California Created a Medicaid Program Vulnerability by Reporting Placeholders That Did Not Represent Actual Expenditures Supported by Documentation (A-09-15-02027)
- California Claimed Millions of Dollars in Unallowable Federal Medicaid Reimbursement for Specialty Mental Health Services (A-09-15-02040)
- Updated Virginia and Washington State False Claims Act Review Letters
- 08-15-2018
- Updated: Work Plan
- 08-14-2018
- Maryland Did Not Adequately Secure Its Medicaid Data and Information Systems (A-18-16-30520)
- Advisory Opinion 18-08 (regarding a proposal by certain government-operated fire departments and fire protection districts to enter into a mutual aid agreement to provide backup emergency ambulance services and to bill for such services according to the billing practices in the jurisdiction where such services are rendered)
- 08-13-2018
- Assistant Attorney General Benczkowski Announces Newark/Philadelphia Medicare Fraud Strike Force to Focus on Health Care Fraud and Illegal Opioid Prescriptions
- Alaska Received Millions in Unallowable Bonus Payments (A-04-17-08059)
- CMS Did Not Always Accurately Authorize Financial Assistance Payments to Qualified Health Plan Issuers in Accordance With Federal Requirements During the 2014 Benefit Year (A-02-15-02013)
- 08-10-2018
- LEIE Database Updated with July 2018 Exclusions and Reinstatements
- 08-09-2018
- Questionable Billing for Compounded Topical Drugs in Medicare Part D (OEI-02-16-00440)
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2016 Average Sales Prices (OEI-03-18-00120)
- Updated Corporate Integrity Agreement List
- 08-08-2018
- Medicare Compliance Review of WakeMed Raleigh Campus (A-04-17-04057)
- Open Payments Data: Review of Accuracy, Precision, and Consistency in Reporting (OEI-03-15-00220)
- 08-06-2018
- Advisory Opinion 18-07 (regarding a proposal from a group purchasing organization ("GPO") to serve as a purchasing agent on behalf of certain GPO-affiliated health care facilities on the same terms and conditions that apply to its unaffiliated members)
- Updated Corporate Integrity Agreement List
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 08-03-2018
- Illinois Did Not Always Comply With Maternal, Infant, and Early Childhood Home Visiting Program Requirements (A-05-16-00066)
- Georgia Implemented Most New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-04-18-03578)
- New Hampshire Implemented Most New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-01-18-02500)
- Illinois Did Not Comply With Federal Waiver and State Requirements at 18 of 20 Adult Day Service Centers Reviewed (A-05-17-00028)
- Updated Provider Self-Disclosure Settlements
- 08-02-2018
- Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part A Administrative Costs for Fiscal Year 2013 (A-05-16-00052)
- Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part B Administrative Costs for Fiscal Year 2013 (A-05-16-00053)
- 08-01-2018
- Updated: Work Plan
- Job Opening: Associate Counsel Application Deadline: August 24, 2018
- 07-31-2018
- Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio
- Media Materials: Vulnerabilities in Hospice Care
- Eye on Oversight: Hospice
- Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: Top Unimplemented Recommendations
- 07-25-2018
- Updated Stipulated Penalties and Exclusion for Material Breach
- 07-23-2018
- First Coast Service Options, Inc., Did Not Claim Some Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals (A-07-18-00536)
- First Coast Service Options, Inc., Generally Claimed Allowable Pension Costs Through Its Incurred Cost Proposals (A-07-18-00534)
- 07-20-2018
- Updated Corporate Integrity Agreement List
- 07-18-2018
- Medicare Improperly Paid Providers for Nonemergency Ambulance Transports to Destinations Not Covered by Medicare (A-09-17-03018)
- Setting Medicare Payment Rates for Clinical Diagnostic Laboratory Tests: Strategies To Ensure Data Quality (OEI-09-17-00050)
- Updated Corporate Integrity Agreement List
- Advisory Opinion 18-06 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay)
- 07-17-2018
- Testimony of Gloria L. Jarmon, Deputy Inspector General for Audit Services, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Ways and Means Subcommittee on Oversight: Combating Fraud in Medicare: A Strategy for Success
- 07-16-2018
- Updated: Work Plan
- 07-13-2018
- The Office of the Secretary of Health and Human Services Did Not Comply with Federal Regulations for Chartered Aircraft and Other Government Travel Related to Former Secretary Price (A-12-17-00002)
- The MEDIC Produced Some Positive Results but More Could be Done to Enhance its Effectiveness (OEI-03-17-00310)
- 07-12-2018
- Weaknesses Exist in Medicaid Managed Care Organizations' Efforts To Identify and Address Fraud and Abuse (OEI-02-15-00260)
- The Colorado Health Insurance Marketplace's Financial Management System Did Not Always Comply With Federal Requirements (A-07-17-02808)
- 07-10-2018
- LEIE Database Updated with June 2018 Exclusions and Reinstatements
- Opioids in Ohio Medicaid: Review of Extreme Use and Prescribing (OEI-05-18-00010)
- The Indian Health Service's Controls Were Not Effective in Ensuring That Its Purchase Card Program Complied With Federal Requirements and Its Own Policy (A-07-16-05090)
- Medicare Improperly Paid Providers for Items and Services Ordered by Chiropractors (A-09-17-03002)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 07-06-2018
- The Administration for Children and Families Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements (A-07-17-03225)
- Some New York City Childcare Providers Did Not Always Comply With Health and Safety Requirements (A-02-16-02003)
- University of Wisconsin Hospitals and Clinics Authority Incorrectly Billed Medicare Inpatient Claims With Severe Malnutrition (A-03-17-00005)
- Updated Provider Self-Disclosure Settlements
- 07-05-2018
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 06-29-2018
- Michigan Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Brokerage Program (A-05-16-00021)
- CMS Did Not Detect Some Inappropriate Claims for Durable Medical Equipment in Nursing Facilities (OEI-06-16-00380)
- 06-28-2018
- 2018 National Takedown
- Featured Topic: Combatting the Opioid Epidemic
- Opioid Use in Medicare Part D Remains Concerning (OEI-02-18-00220)
- Toolkit: Using Data Analysis To Calculate Opioid Levels and Identify Patients At Risk of Misuse or Overdose (OEI-02-17-00560)
- Entities Generally Met Federal Select Agent Program Internal Inspection Requirements But CDC Could Do More To Improve Effectiveness (OEI-04-15-00431)
- 06-27-2018
- Testimony of Brian P. Ritchie, Assistant Inspector General for Audit Services, Office of Inspector General, U.S. Department of Health and Human Services: Senate Committee on Homeland Security and Governmental Affairs: Medicaid Fraud and Overpayments: Problems and Solutions
- Updated: Work Plan
- Tennessee Medicaid Fraud Control Unit: 2017 Onsite Inspection (OEI-12-17-00230)
- 06-26-2018
- Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2018 (OEI-05-18-00240)
- Updated Corporate Integrity Agreement List
- 06-25-2018
- Advisory Opinion 18-05 (regarding an arrangement under which a hospital has established a caregiver center that provides or arranges for free or reduced-cost support services to caregivers in the local community)
- 06-22-2018
- Florence Crittenton Services of Orange County, Inc., Did Not Always Meet Applicable Safety Standards Related to Unaccompanied Alien Children (A-09-16-01005)
- 06-19-2018
- Updated Corporate Integrity Agreement List
- 06-18-2018
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 06-15-2018
- Updated: Work Plan
- 06-14-2018
- Advisory Opinion 18-04 regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby insurance companies would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for their policyholders and, in turn, would provide a premium credit of $100 to policyholders who use a network hospital for an inpatient stay
- 06-13-2018
- Podcast: Pain Management Doctor Was A "One-Man Crime Wave"
- Nebraska Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-07-17-03224)
- Illinois Implemented Most New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-05-17-00047)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 06-12-2018
- Most Medicare Claims for Replacement Positive Airway Pressure Device Supplies Did Not Comply With Medicare Requirements (A-04-17-04056)
- Companion Data Services, LLC, Did Not Claim Some Allowable Pension Costs Through Its Incurred Cost Proposals (A-07-17-00528)
- Minnesota Did Not Comply With Federal Waiver and State Requirements for All 20 Adult Day Care Centers Reviewed (A-05-17-00009)
- Ohio Did Not Always Comply With Requirements Related to the Case Management of Children in Foster Care (A-05-16-00022)
- 06-08-2018
- LEIE Database Updated with May 2018 Exclusions and Reinstatements
- Texas Made Increased Payments for Services Rendered by Eligible Primary Care Providers Under Federal Requirements (A-06-17-09003)
- Nevada Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-09-15-02039)
- Updated Corporate Integrity Agreement List
- 06-07-2018
- The Food and Drug Administration Computed Prescription Drug User Fee Rates Accurately (A-05-17-00040)
- 06-06-2018
- New York Claimed Federal Reimbursement for Consumer-Directed Personal Assistance Services That Did Not Meet Medicaid Requirements (A-02-16-01026)
- Updated Provider Self-Disclosure Settlements
- 06-05-2018
- 2017 Performance Data for the Senior Medicare Patrol Projects (OEI-02-18-00130)
- Updated Corporate Integrity Agreement List
- 06-04-2018
- Increases in Reimbursement for Brand-Name Drugs in Part D (OEI-03-15-00080)
- Podcast: Increases in Reimbursement for Brand-Name Drugs in Part D
- 06-01-2018
- Semiannual Report to Congress
- 05-31-2018
- Advisory Opinion 18-03 regarding a federally qualified health center look-alike's proposal to provide information technology items and services, without charge, to a county Department of Health's clinic to facilitate telemedicine encounters
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 05-30-2018
- HRSA Helped Health Centers With Elevated Risks and Can Continue To Take Additional Steps (OEI-05-14-00470)
- 05-29-2018
- Testimony of Maureen Dixon, Special Agent in Charge, Philadelphia Regional Office, Office of Investigations, Office of Inspector General, Department of Health and Human Services: Senate Committee on Finance Health Care Subcommittee Field Hearing: Examining Efforts to Prevent Opioid Overutilization and Misuse in Medicare and Medicaid
- 05-25-2018
- Eye on Oversight: Corporate Integrity Agreements
- 05-24-2018
- Round 2 Competitive Bidding for Enteral Nutrition: Continued Access for Vast Majority of Beneficiaries (OEI-01-15-00042)
- Round 2 Competitive Bidding for Oxygen: Continued Access for Vast Majority of Beneficiaries (OEI-01-15-00041)
- CMS Did Not Always Provide Accurate Medicaid Unit Rebate Offset Amounts to State Medicaid Agencies (A-07-17-06074)
- Updated Corporate Integrity Agreement List
- 05-23-2018
- Testimony of Gary Cantrell, Deputy Inspector General for Investigations, Office of Investigations, Office of Inspector General, Department of Health and Human Services: Senate Special Committee on Aging: Preventing and Treating Opioid Misuse Among Older Americans
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 05-22-2018
- The South African National Department of Health Did Not Always Manage and Expend the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements (A-04-17-01002)
- 05-18-2018
- Iowa Complied With Most Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-07-17-03221)
- Missouri Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-07-16-03216)
- 05-16-2018
- The University of Alabama at Birmingham Overstated Chilled Water Costs in Its Facilities and Administrative Cost Proposal Audit (A-04-14-00095)
- Wisconsin Physicians Service Insurance Corporation Understated Medicare Administrative Contract Allowable Pension Costs (A-07-17-00530)
- Wisconsin Physicians Service Insurance Corporation Understated Medicare�s Share of the Medicare Segment Excess Pension Assets (A-07-17-00529)
- 05-15-2018
- Testimony of Ann Maxwell, Assistant Inspector General for Evaluation and Inspections, Office of Inspector General, Department of Health and Human Services: Senate Committee on Health, Education, Labor, and Pensions: Examining Oversight Reports on the 340B Drug Pricing Program
- Updated: Work Plan
- U.S. Department of Health and Human Services Met Many Requirements of the Improper Payments Information Act of 2002 but Did Not Fully Comply for Fiscal Year 2017 (A-17-18-52000)
- 05-14-2018
- New Most Wanted Fugitive Posted: Angel Lagoa allegedly paid illegal kickbacks to patient recruiters in exchange for beneficiary information.
- 05-11-2018
- Most of New York's Claims for Federal Reimbursement for Monthly Personal Emergency Response Service Charges Did Not Comply With Medicaid Requirements (A-02-15-01019)
- 05-09-2018
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 05-08-2018
- LEIE Database Updated with April 2018 Exclusions and Reinstatements
- Daniel R. Levinson's Keynote Address at the 2018 HCCA Compliance Institute
- The National Institutes of Health, Division of Financial Advisory Services Did Not Always Establish Final Indirect Cost Rates in Accordance With Federal Requirements (A-04-17-04059)
- Updated Corporate Integrity Agreement List
- 05-07-2018
- Advisory Opinion 18-02 (regarding an arrangement where a company that manufactures, distributes, and sells medical device and pharmaceutical products provides a limited number of free sample ostomy products to patients and contracts with a third party to conduct follow-up customer satisfaction surveys)
- Updated Corporate Integrity Agreement List
- Cahaba Safeguard Administrators, LLC, Understated Medicare Administrative Contract Allowable Pension Costs (A-07-17-00526)
- Cahaba Government Benefits Administrators, LLC, Understated Medicare Administrative Contract Allowable Pension Costs (A-07-17-00525)
- Cahaba Government Benefits Administrators, LLC, Generally Claimed Allowable Medicare Pension Costs (A-07-17-00524)
- Cahaba Government Benefits Administrators, LLC, Overstated Its Medicare Segment Pension Assets (A-07-17-00522)
- 05-04-2018
- Florida Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-04-17-08052)
- Cahaba Safeguard Administrators, LLC, Understated Its Medicare Segment Pension Assets (A-07-17-00523)
- First Coast Service Options, Inc.'s, Postretirement Benefit Costs Were Reasonable and Allowable (A-07-17-00501)
- 05-03-2018
- Updated Provider Self-Disclosure Settlements
- 05-01-2018
- This is Real: Go Undercover with Our New Podcast
- 04-30-2018
- Wanted: Amaury Perez
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 04-24-2018
- Colorado Did Not Always Comply With Federal Requirements When Expending Federal Establishment Grant Funds Allocated for Its Shared Eligibility System Costs (A-07-16-02804)
- 04-20-2018
- The National Institute of Health in Mozambique Did Not Always Manage and Expend the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements (A-04-16-04051)
- Updated Corporate Integrity Agreement List
- 04-18-2018
- The Indian Health Service's Controls Were Not Effective in Ensuring That Its Travel Card Program Complied With Federal Requirements and Its Own Policy (A-07-16-05091)
- CMS's Policies and Procedures Were Generally Effective in Ensuring That Prescription Drug Coverage Capitation Payments Were Not Made After the Beneficiaries' Dates of Death (A-07-16-05088)
- 04-16-2018
- New: Compliance Resource Portal
- Updated: Work Plan
- 04-13-2018
- CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements (A-05-16-00058)
- Colorado Claimed Some Unallowable Medicaid Payments for Targeted Case Management Services (A-07-16-03215)
- Idaho Received Millions in Unallowable Bonus Payments (A-04-17-08056)
- 04-12-2018
- Testimony of Megan H. Tinker Senior Advisor for Legal Review Office of Counsel to the Inspector General, Office of Inspector General, Department of Health and Human Services: House Committee on Oversight and Government Reform, Subcommittee on Government Operations Subcommittee on Intergovernmental Affairs: Improper Payments in State?Administered Programs: Medicaid
- 04-11-2018
- Most Wanted Fugitive: Ebong Tilong
- Updated Corporate Integrity Agreement List
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 04-10-2018
- LEIE Database Updated with March 2018 Exclusions and Reinstatements
- 04-09-2018
- Texas Did Not Make Increased Primary Care Provider Payments and Claim Reimbursement in Accordance With Federal Requirements (A-06-15-00045)
- 04-06-2018
- FY 2017 Health Care Fraud and Abuse Control Program Report
- 04-04-2018
- Updated Provider Self-Disclosure Settlements
- 03-30-2018
- Medicaid Fraud Control Units Fiscal Year 2017 Annual Report (OEI-09-18-00180)
- 03-29-2018
- Drug Supply Chain Security: Dispensers Received Most Tracing Information (OEI-05-16-00550)
- 03-28-2018
- Updated Corporate Integrity Agreement List
- 03-27-2018
- CAPTURED: Antonio Quevedo-Ledo
- 03-23-2018
- Many Medicare Claims for Outpatient Physical Therapy Services Did Not Comply With Medicare Requirements (A-05-14-00041)
- Oklahoma Did Not Have Procedures to Identify Provider-Preventable Conditions on Some Inpatient Hospital Claims (A-06-16-08004)
- 03-22-2018
- Some Washington State Group-Care Facilities for Children in Foster Care Did Not Always Comply With State Health and Safety Requirements (A-09-16-01006)
- Aurum Institute Generally Managed and Expended the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements (A-04-17-01003)
- New Jersey Claimed Federal Medicaid Reimbursement for Children's Partial Hospitalization Services That Did Not Meet Federal and State Requirements (A-02-16-01008)
- New York Did Not Comply With Federal Grant Requirements for Claiming Marketplace Contract Costs to Medicaid and the Children's Health Insurance Program (A-02-15-01014)
- 03-21-2018
- Small Business Innovation Research (SBIR) Fraud
- 03-16-2018
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 03-15-2018
- Updated: Work Plan
- Hospitals Did Not Comply With Medicare Requirements for Reporting Certain Cardiac Device Credits (A-05-16-00059)
- Updated Corporate Integrity Agreement List
- 03-14-2018
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 03-12-2018
- BCFS Health and Human Services Did Not Always Comply With Federal Requirements Related to Less-Than-Arm's-Length Leases (A-06-16-07007)
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2017 (A-18-17-11200)
- 03-09-2018
- Oklahoma Did Not Always Comply With Requirements for Providing Health Care Services to Children in Foster Care (A-06-16-07006)
- Updated Provider Self-Disclosure Settlements
- 03-08-2018
- Reliance on Unverified Patient Lists Creates a Vulnerability in Home Health Surveys (OEI-05-16-00510)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 03-07-2018
- Updated Corporate Integrity Agreement List
- 03-06-2018
- LEIE Database Updated with February 2018 Exclusions and Reinstatements
- 03-02-2018
- Entities' Experiences and Perceptions of Reporting the Theft, Loss, and Release of Select Agents or Toxins to CDC (OEI-04-15-00432)
- Updated Corporate Integrity Agreement List
- 03-01-2018
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 02-27-2018
- Advisory Opinion 18-01 (regarding the effect of your exclusion from Medicare, Medicaid, and all other Federal health care programs)
- 02-23-2018
- The National Institutes of Health Did Not Always Administer Superfund Appropriations During Fiscal Year 2015 in Accordance With Federal Requirements (A-04-16-04046)
- 02-21-2018
- Medicare Compliance Review of Memorial University Medical Center (A-04-17-08055)
- The Association for Public Health Laboratories Managed Global Health Security Agenda Funds in Accordance With Federal Requirements (A-04-17-02004)
- California Made Medicaid Payments on Behalf of Newly Eligible Beneficiaries Who Did Not Meet Federal and State Requirements (A-09-16-02023)
- Updated Corporate Integrity Agreement List
- 02-20-2018
- Fall Internship Application
- Arizona Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02031)
- Medicare Improperly Paid Providers for Specimen Validity Tests Billed in Combination With Urine Drug Tests (A-09-16-02034)
- 02-16-2018
- Medicare Needs Better Controls To Prevent Fraud, Waste, and Abuse Related to Chiropractic Services (A-09-16-02042)
- 02-15-2018
- Updated: Work Plan
- Wisconsin Physicians Service Paid Providers for Hyperbaric Oxygen Therapy Services That Did Not Comply With Medicare Requirements (A-01-15-00515)
- Arkansas Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-06-16-00018)
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2016 (A-18-17-11300)
- 02-13-2018
- Updated Corporate Integrity Agreement List
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 02-12-2018
- FY 2019 Congressional Budget Justification
- 02-09-2018
- Updated Corporate Integrity Agreement List
- 02-08-2018
- Henry J. Austin Health Center, Inc., a Health Resources and Services Administration Grantee, Did Not Comply With Federal Grant Requirements (A-02-17-02002)
- The Administration for Children and Families Region II Did Not Always Resolve Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements (A-02-16-02009)
- 02-07-2018
- LEIE Database Updated with January 2017 Exclusions and Reinstatements
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Pension Costs Through Its Incurred Cost Proposals (A-07-17-00506)
- CGS Administrators, LLC, Did Not Claim Some Allowable Pension Costs Through Its Incurred Cost Proposals (A-07-17-00513)
- 02-06-2018
- Medicare Compliance Review of the University of Michigan Health System (A-05-16-00064)
- Updated Corporate Integrity Agreement List
- 01-23-2018
- North Carolina Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-04-17-02500)
- Medicare Compliance Review of Carolinas Medical Center (A-04-16-04049)
- 01-19-2018
- Testimony of Gloria Jarmon, Deputy Inspector General for the Office of Audit Services, Department of Health and Human Services: House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations: Safety of the U.S. Food Supply: Continuing Concerns Over the Food and Drug Administration's Food-Recall Process
- Updated Corporate Integrity Agreement List
- 01-18-2018
- Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2017 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00354)
- Independent Attestation Review: Substance Abuse and Mental Health Services Administration Fiscal Year 2017 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00353)
- Independent Attestation Review: National Institutes of Health Fiscal Year 2017 Detailed Accounting Submissions and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00352)
- Independent Attestation Review: Indian Health Service Fiscal Year 2017 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00351)
- 01-17-2018
- Joint Report: Ensuring Beneficiary Health and Safety in Group Homes Through State Implementation of Comprehensive Compliance Oversight
- Testimony of Gary Cantrell, Deputy Inspector General for Investigations, Office of Investigations, Office of Inspector General, Department of Health and Human Services: House Committee on Ways and Means, Subcommittee on Oversight: The Opioid Crisis: The Current Landscape and CMS Actions to Prevent Opioid Misuse
- Wisconsin Physicians Service Insurance Corporation Did Not Claim Some Allowable Medicare Pension Costs (A-07-17-00519)
- Wisconsin Physicians Service Insurance Corporation Understated Its Allocable Pension Costs (A-07-17-00520)
- Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2017 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00355)
- 01-16-2018
- Updated: Work Plan
- Medicare Advantage Encounter Data Show Promise for Program Oversight, But Improvements Are Needed (OEI-03-15-00060)
- Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Employees' Pension Plan (A-07-17-00516)
- Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Managerial Retirement Program for Selected Locations (A-07-17-00517)
- Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Managerial Pension Plan (A-07-17-00518)
- 01-09-2018
- New York Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries (A-02-15-01015)
- Tennessee Managed Care Organizations Received Medicaid Capitation Payments After Beneficiary's Death (A-04-15-06190)
- Georgia Made Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid Identification Numbers (A-04-16-07061)
- Texas Did Not Appropriately Spend Some State Balancing Incentive Payments Program Funds (A-06-15-00041)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 01-08-2018
- Texas Did Not Always Calculate Physician Supplemental Payments Made to the Texas Tech University Health Institutions in Accordance With Federal and State Requirements (A-06-12-00043)
- Nebraska Did Not Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-07-13-06046)
- Texas Did Not Bill Manufacturers for Some Rebates for Pharmacy Drugs of Medicaid Managed-Care Organizations (A-06-16-00004)
- Indiana Did Not Always Comply With Maternal, Infant, and Early Childhood Home Visiting Program Requirements (A-05-16-00056)
- Updated Corporate Integrity Agreement List
- 01-05-2018
- OIG Letter to PhRMA: Drug Companies that Provide Free Drugs to Federal Health Care Program Beneficiaries Impacted by Caring Voice Coalition, Inc.'s Decision Not to Provide Patient Assistance in 2018
- Advisory Opinion 17-09 (regarding an arrangement in which certain neurosurgeons have agreed to implement cost-reduction measures in designated surgical procedures performed at a medical center, and the medical center will share with such neurosurgeons a percentage of its cost savings resulting from these measures)
- 01-04-2018
- Updated Corporate Integrity Agreement List
- 01-03-2018
- LEIE Database Updated with December 2017 Exclusions and Reinstatements
- Updated Provider Self-Disclosure Settlements
September
August
July
June
May
April
March
February
January
-
December
- 12-29-2017
- Updated Civil Monetary Penalties and Affirmative Exclusions
- New York Did Not Comply With Federal Grant Requirements for Allocating and Claiming Marketplace Contract Costs (A-02-15-02008)
- 12-26-2017
- The Food and Drug Administration's Food-Recall Process Did Not Always Ensure the Safety of the Nation's Food Supply (A-01-16-01502)
- 12-22-2017
- The Administration for Children and Families Region X Did Not Always Resolve Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements (A-09-16-01004)
- 12-21-2017
- Lincare Pharmacy Services Inc. Generally Complied With Medicare Requirements When Billing for Inhalation Drugs (A-09-16-02037)
- Taxpayers Could See More than $4.4 Billion Returned to Treasury Plus $Billions in Estimated 2017 Savings from OIG Recommendations
- 12-20-2017
- Eye on Oversight: 2017 Year in Review
- Potential Misclassifications Reported by Drug Manufacturers May Have Led to $1 Billion in Lost Medicaid Rebates (OEI-03-17-00100)
- Updated Corporate Integrity Agreement List
- 12-19-2017
- The Administration for Children and Families Did Not Always Resolve American Indian and Alaska Native Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements (A-06-17-07003)
- Summary Report for Fiscal Year 2016 OIG Penetration Testing of Four HHS Operating Division Networks (A-18-17-08500)
- 12-18-2017
- The State of North Carolina Did Not Meet Federal Information System Security Requirements for Safeguarding Its Medicaid Eligibility Determination Systems and Data (A-07-16-00486)
- Some Massachusetts Group Homes for Children in Foster Care Did Not Always Comply With State Health and Safety Requirements (A-01-16-02500)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 12-15-2017
- Updated: Work Plan
- Advisory Opinion 17-08 (regarding your proposal to develop a state-wide network of nursing facilities that would provide discounts on the daily rates they charge to private long-term care insurers and the insurers' policyholders)
- 12-14-2017
- Followup Review: CMS's Management of the Quality Payment Program (OEI-12-17-00350)
- Updated Corporate Integrity Agreement List
- 12-11-2017
- Advisory Opinion 17-07 (regarding a pharmaceutical manufacturer's proposal to collaborate with a trade association, a Medicare Advantage plan, and a hospital system to implement, fund, and evaluate a pilot program to provide the Medicare Advantage plan pharmacists who conduct medication therapy management services with new technology that would permit real-time electronic access to patient discharge information)
- 12-08-2017
- Medicaid Fraud Control Units: Investigation and Prosecution of Fraud and Beneficiary Abuse in Medicaid Personal Care Services (OEI-12-16-00500)
- Office of Refugee Resettlement Unaccompanied Alien Children Grantee Review—His House (A-04-16-03566)
- 12-07-2017
- Pine Bluff Jefferson County Economic Opportunities Commission Did Not Always Operate Its Head Start Program in Accordance With Federal Requirements (A-06-16-00013)
- Not All of Missouri's Child Care Subsidy Program Payments Complied With Federal and State Requirements (A-07-15-04226)
- Two Indian Health Service Hospitals Had System Security and Physical Controls for Prescription Drug and Opioid Dispensing but Could Still Improve Controls (A-18-16-30540)
- Updated Corporate Integrity Agreement List
- 12-06-2017
- Updated Provider Self-Disclosure Settlements
- 12-05-2017
- LEIE Database Updated with November 2017 Exclusions and Reinstatements
- Updated Corporate Integrity Agreement List
- 12-01-2017
- CMS Did Not Adequately Address Discrepancies in the Coding Classification for Kwashiorkor (A-03-14-00010)
- Texas Managed Care Organizations Received Medicaid Capitation Payments After Beneficiary's Death (A-06-16-05004)
November
- 11-30-2017
- Fall Semiannual Report to Congress
- 11-29-2017
- Updated Corporate Integrity Agreement List
- 11-28-2017
- Final Notice of Rescission of Advisory Opinion 06-04 (rescinds Advisory Opinion 06-04, which concerned a nonprofit, tax-exempt, charitable corporation's proposal to provide financially needy Medicare beneficiaries with assistance with premiums and cost-sharing obligations)
- New Jersey Claimed Hundreds of Millions in Unallowable or Unsupported Medicaid School-Based Reimbursement (A-02-15-01010)
- 11-27-2017
- Excluding Noncovered Versions When Setting Payment for Two Part B Drugs Would Have Resulted in Lower Drug Costs for Medicare and its Beneficiaries (OEI-12-17-00260)
- 11-20-2017
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 11-17-2017
- CMS Generally Met Requirements in Round 2 of the DMEPOS Competitive Bidding Program (A-05-14-00049)
- Updated Corporate Integrity Agreement List
- 11-16-2017
- Eye on Oversight Video: Grant Management
- Medicare Compliance Review of Rush University Medical Center (A-05-16-00062)
- U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, but Key Areas Require Improvement (A-17-17-02018)
- Advisory Opinion 17-06 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would indirectly contract with hospitals for discounts on the otherwise applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 to policyholders who use a network hospital for an inpatient stay)
- 11-15-2017
- Top Management & Performance Challenges Facing HHS
- Updated: Work Plan
- Updated: CIA Reportable Event Settlements
- 11-13-2017
- North Carolina Did Not Comply With Federal and State Requirements When Making Medicaid Cost-Sharing Payments for Professional Medical Services (A-04-16-04054)
- 11-09-2017
- Ohio Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-16-00013)
- Oklahoma Did Not Correctly Process Adjustments to Medicare Crossover Claims (A-06-16-08012)
- New York Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-02-15-01024)
- 11-08-2017
- From Military Veteran to OIG Special Agent
- 11-07-2017
- LEIE Database Updated with October 2017 Exclusions and Reinstatements
- Kansas Received Millions in Unallowable Bonus Payments (A-04-16-08050)
- Ohio Received Millions in Unallowable Bonus Payments (A-04-16-08049)
- 11-06-2017
- Minnesota Did Not Comply With Federal Waiver and State Requirements for 18 of 20 Family Adult Foster Care Homes Reviewed (A-05-16-00044)
- Updated Corporate Integrity Agreement List
- 11-03-2017
- First Coast Service Options, Inc., Generally Claimed Allowable Medicare Pension Costs (A-07-16-00495)
- First Coast Service Options, Inc., Understated Its Medicare Segment Pension Assets (A-07-16-00494)
- First Coast Service Options, Inc., Understated Its Allocable Pension Costs (A-07-16-00493)
- 11-02-2017
- CMS Ensured Nearly All Part D Drug Records Contained Valid Prescriber Identifiers in 2016 (OEI-03-17-00040)
- New York Did Not Always Ensure That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV-E Foster Care Payments Were Recorded and Investigated in Accordance With State Requirements as Required by Federal Law (A-02-15-02014)
- Updated Corporate Integrity Agreement List
- Updated Provider Self-Disclosure Settlements
- 11-01-2017
- Southeast Arkansas Community Action Corporation Did Not Always Operate Its Head Start Program in Accordance With Federal Regulations (A-06-16-00015)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- Updated Corporate Integrity Agreement List
October
- 10-31-2017
- Testimony of James A. Cannatti III, Senior Counselor for Health Information Technology, Office of Inspector General, U.S. Department of Health and Human Services: Senate Committee on Health, Education, Labor, and Pensions: Implementation of the 21st Century Cures Act: Achieving the Promise of Health Information Technology
- 10-27-2017
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 10-25-2017
- Review of The Department of Health and Human Services (HHS) Cancellation of Marketplace Enrollment Outreach Efforts (OEI-12-17-00290)
- HRSA Complied With Federal and HHS Grant Policies When Awarding Zika Response and Preparedness Appropriations Act Funds During Fiscal Year 2017
- 10-23-2017
- CMS Ensured That Medicare Shared Savings Program Beneficiaries Were Properly Assigned: Beneficiaries Were Assigned to Only One Accountable Care Organization and Were Not Assigned to Other Shared Savings Programs (A-09-17-03010)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 10-19-2017
- Updated Corporate Integrity Agreement List
- 10-16-2017
- Updated: Work Plan
- 10-12-2017
- CMS's Policies and Procedures Were Generally Effective in Ensuring That Capitation Payments Were Not Made After Beneficiaries' Dates of Death (A-07-16-05087)
- 10-11-2017
- Job Opening: Attorney Application Deadline: October 20, 2017
- Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part B Administrative Costs for Fiscal Year 2012 (A-05-15-00047)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 10-06-2017
- Some Ohio Group Homes Did Not Always Comply With Foster Care Health and Safety Requirements (A-05-16-00049)
- National Government Services Properly Claimed Allowable Administrative Costs for the Last Three Quarters of Fiscal Years 2011 and 2012 Under Medicare Contract 00630 (A-05-15-00045)
- National Government Services Properly Claimed Allowable Administrative Costs for the Last Three Quarters of Fiscal Years 2011 and 2012 Under Medicare Contract 00130 (A-05-16-00034)
- National Government Services Properly Claimed Allowable Administrative Costs for the Last Three Quarters of Fiscal Years 2011 and 2012 Under Medicare Contract 00450 (A-05-16-00035)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 10-05-2017
- The Food and Drug Administration Generally Spent Prescription Drug User Fee Collections Appropriately (A-05-16-00040)
- The Administration for Children and Families Region VI Did Not Always Resolve Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements (A-06-16-00019)
- The District of Columbia Claimed Some Day Treatment Program Services That Were Not in Compliance With Federal or District Requirements (A-03-16-00201)
- 10-04-2017
- Podcast: Health IT Security
- LEIE Database Updated with September 2017 Exclusions and Reinstatements
- Updated Corporate Integrity Agreement List
- 10-03-2017
- Medicare Payments for Clinical Diagnostic Laboratory Tests in 2016: Year 3 of Baseline Data (OEI-09-17-00140)
- The Turtle Mountain Band of Chippewa Indians Improperly Administered Some Low-Income Home Energy Assistance Program Funds for Fiscal Years 2010 Through 2013 (A-07-16-04233)
- Updated Provider Self-Disclosure Settlements
- 10-02-2017
- Protect Yourself from Medical Identity Theft
- Shortcomings of Device Claims Data Complicate and Potentially Increase Medicare Costs for Recalled and Prematurely-Failed Devices (A-01-15-00504)
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2015 Average Sales Prices (OEI-03-17-00360)
- Wyoming State Medicaid Fraud Control Unit: 2016 Onsite Review (OEI-09-16-00530)
September
- 09-29-2017
- A Few States Fell Short in Timely Investigation of the Most Serious Nursing Home Complaints: 2011-2015 (OEI-01-16-00330)
- Enhancements Needed in the Tracking and Collection of Medicare Overpayments Identified by ZPICs and PSCs (OEI-03-13-00630)
- The Centers for Medicare & Medicaid Services Could Improve Performance Measures Associated With the Fraud Prevention System (A-01-15-00509)
- Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part A Administrative Costs for Fiscal Year 2012 (A-05-15-00046)
- 09-28-2017
- Hawaii Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02029)
- Washington State Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02028)
- CMS Did Not Provide Effective Oversight To Ensure That State Marketplaces Always Properly Determined Individuals' Eligibility for Qualified Health Plans and Insurance Affordability Programs (A-09-16-01002)
- Some Oklahoma Group Homes Did Not Always Comply With State Requirements (A-06-16-07004)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 09-27-2017
- Challenges Remain in FDA's Inspections of Domestic Food Facilities (OEI-02-14-00420)
- 09-26-2017
- California Did Not Always Ensure That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV E Foster Care Payments Were Properly Recorded, Investigated, and Resolved (A-09-16-01000)
- Integrated Health Administrative Services, Inc., Improperly Claimed Medicare Part B Reimbursement for Portable X-ray Services (A-02-15-01008)
- Minnesota Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Program (A-05-15-00026)
- Massachusetts Generally Complied With State Requirements To Ensure Children Who Were Title IV-E Eligible and Residing in Foster Care Congregate Care Group Homes Received Required Medical Services (A-01-16-02501)
- 09-22-2017
- Kentucky State Medicaid Fraud Control Unit: 2017 Onsite Review (OEI-06-17-00030)
- Alaska State Medicaid Fraud Control Unit: 2016 Onsite Review (OEI-09-16-00430)
- Medicare Compliance Review of Parkridge Medical Center, Inc., for 2014 and 2015 (A-04-16-08048)
- Vulnerabilities Remain in Medicare Hospital Outlier Payments (A-07-14-02800)
- 09-21-2017
- Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities (A-09-16-02026)
- 09-20-2017
- OHRP Should Inform Potential Complainants of How They Can Seek Whistleblower Protections (OEI-01-15-00351)
- Alabama Did Not Adequately Secure Its Medicaid Data and Information Systems (A-04-15-05065)
- 09-19-2017
- Wisconsin Did Not Always Comply With Maternal, Infant, and Early Childhood Home Visiting Program Requirements (A-05-15-00049)
- Blue Cross Blue Shield Association Generally Claimed Allowable Medicare Postretirement Benefit Costs (A-07-17-00521)
- Nevada Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02027)
- Sierra Nevada Memorial Hospital Did Not Accurately Report Certain Wage Data, Resulting in Overpayments to California Hospitals (A-09-16-02044)
- 09-15-2017
- Updated: Work Plan
- Drug Supply Chain Security: Wholesalers Exchange Most Tracing Information (OEI-05-14-00640)
- Updated Corporate Integrity Agreement List
- 09-13-2017
- Job Opening: Experienced Litigator Application Deadline: September 27, 2017
- Arkansas Did Not Make Supplemental Payments in Accordance With Federal Requirements (A-06-15-00042)
- 09-12-2017
- New York State Improperly Claimed Medicaid Reimbursement for Some Managed Long-Term Care Payments (A-02-15-01026)
- CMS Oversight Must Continue Because All Remaining Consumer Operated and Oriented Plans Were Not Profitable and May Not Be Viable and Sustainable (A-05-16-00027)
- Companion Data Services, LLC, Understated Its Allocable Pension Costs (A-07-17-00511)
- Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets (A-07-17-00512)
- Updated Provider Self-Disclosure Settlements
- 09-11-2017
- OCIG Spring and Summer Internship Opportunities
- Kansas Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-07-17-03218)
- Blue Cross Blue Shield of South Carolina Overstated Its Allocable Qualified Pension Plan Costs (A-07-17-00509)
- CMS and Its Claims Processing Contractors Issued Conflicting Guidance on the Proper Use of the KX Modifier for Part B Immunosuppressive Drug Claims (A-06-15-00018)
- 09-08-2017
- Challenges Appear to Limit States' Use of Medicaid Payment Suspensions (OEI-09-14-00020)
- 09-07-2017
- LEIE Database Updated with August 2017 Exclusions and Reinstatements
- Advisory Opinion 17-05 (regarding a retail pharmacy chain's proposal to allow Federal health care program beneficiaries to participate in a paid membership program that includes discounts on certain prescriptions and clinic services)
- Updated Corporate Integrity Agreement List
- 09-05-2017
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2014 Average Sales Prices (OEI 03-16-00540)
- Calculation of Potential Inflation-Indexed Rebates For Medicare Part B Drugs 2017 (OEI-12-17-00180)
- 09-01-2017
- Oklahoma Did Not Adequately Oversee Its Medicaid Nonemergency Medical Transportation Program (A-06-16-00007)
August
- 08-31-2017
- As Funding for BPA Research Increased, NIEHS Followed Its Peer Review Process While Also Exercising Its Discretion (OEI-01-15-00150)
- Advisory Opinion 17-04 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby insurance companies indirectly contract with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for their policyholders and, in turn, provide a premium credit of $100 to policyholders who use a network hospital for an inpatient stay)
- 08-30-2017
- Updated Corporate Integrity Agreement List
- 08-29-2017
- Fox Rehabilitation Claimed Unallowable Medicare Reimbursement for Outpatient Therapy Services (A-02-16-01004)
- Accredo Health Group, Inc., Properly Billed Medicare for Inhalation Drugs (A-09-16-02022)
- Medicare Shared Savings Program Accountable Care Organizations Have Shown Potential for Reducing Spending and Improving Quality (OEI-02-15-00450)
- 08-28-2017
- Early Alert: The Centers for Medicare & Medicaid Services Has Inadequate Procedures To Ensure That Incidents of Potential Abuse or Neglect at Skilled Nursing Facilities Are Identified and Reported in Accordance With Applicable Requirements (A-01-17-00504)
- Job Opening: Attorney Application Deadline: September 22, 2017
- 08-25-2017
- Advisory Opinion 17-03 (regarding a pharmaceutical manufacturer's proposal to replace products that require specialized handling that could not be administered to patients for certain reasons, at no additional charge to the purchaser)
- 08-24-2017
- TrailBlazer Health Enterprises, LLC, Claimed Some Unallowable Medicare Administrative Contract Pension Costs (A-07-17-00510)
- 08-23-2017
- Colorado State Medicaid Fraud Control Unit: 2016 Onsite Review (OEI 06-16-00520)
- 08-22-2017
- FDA Oversight of Tobacco Manufacturing Establishments (OEI-01-15-00300)
- 08-21-2017
- Kentucky Did Not Always Perform Medicaid Eligibility Determinations for Non-Newly Eligible Beneficiaries in Accordance With Federal and State Requirements (A-04-16-08047)
- Public Summary Report: The State of North Carolina Did Not Ensure That Federal Information System Security Requirements Were Met for Safeguarding Its Medicaid Claims Processing Systems and Data (A-07-16-00469)
- 08-18-2017
- Public Summary Report: Information Technology Control Weaknesses Found in the New Mexico Human Services Department's Medicaid Eligibility Systems (A-06-16-05000)
- A Brooklyn Chiropractor Received Unallowable Medicare Payments for Chiropractic Services (A-02-13-01047)
- The Ministry of Health and Social Welfare National AIDS Control Program Did Not Always Manage and Expend PEPFAR Funds in Accordance With Award Requirements (A-04-16-04044)
- The Administration for Children and Families Region IX Resolved Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements (A-09-16-01003)
- 08-17-2017
- Updated Corporate Integrity Agreement List
- 08-16-2017
- Texas Improperly Received Medicaid Reimbursement for School-Based Health Services (A-06-14-00002)
- 08-15-2017
- Updated: Work Plan
- 08-14-2017
- TrailBlazer Health Enterprises, LLC, Understated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Assets (A-07-17-00507)
- TrailBlazer Health Enterprises, LLC, Did Not Claim Some Allowable Medicare Pension Costs (A-07-17-00508)
- 08-10-2017
- Maine Did Not Comply With Federal and State Requirements for Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities (A-01-16-00001)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- Updated Corporate Integrity Agreement List
- 08-07-2017
- Eye on Oversight: The Importance of OIG Audits
- LEIE Database Updated with July 2017 Exclusions and Reinstatements
- Updated Provider Self-Disclosure Settlements
- 08-04-2017
- Medicare Paid New England Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays During Calendar Years 2013 and CY 2014 (A-01-15-00511)
- Ohio Ensured That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV-E Foster Care Payments Were Recorded and Investigated in Accordance With State Requirements as Required by Federal Law (A-05-16-00020)
- The Three Affiliated Tribes Improperly Administered Low-Income Home Energy Assistance Program Funds for Fiscal Years 2010 Through 2014 (A-07-16-04230)
- Updated Corporate Integrity Agreement List
- 08-03-2017
- Podcast: Independence of the Office for Human Research Protections
- HHS's Office of Refugee Resettlement Improved Coordination and Outreach to Promote the Safety and Well-Being of Unaccompanied Alien Children (OEI-09-16-00260)
- 08-02-2017
- Updated Corporate Integrity Agreement List
- 08-01-2017
- Updated CIA Reportable Event Settlements
July
- 07-31-2017
- OHRP Generally Conducted Its Compliance Activities Independently, But Changes Would Strengthen Its Independence (OEI-01-15-00350)
- 07-27-2017
- Some Hospitals in Medicare Jurisdiction F Claimed Residents as More Than One Full-Time Equivalent (A-02-15-01028)
- Some Hospitals in Medicare Jurisdiction E Claimed Residents as More Than One Full-Time Equivalent (A-02-15-01027)
- 07-26-2017
- Eye on Oversight: Electronic Health Records
- 07-19-2017
- Review of Pennsylvania Medicaid Managed Care Program Potential Savings With Minimum Medical Loss Ratio (A-03-15-00203)
- 07-18-2017
- Testimony of Erin Bliss, Assistant Inspector General for Evaluation and Inspections, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Energy and Commerce: Subcommittee on Oversight and Investigations: "Examining HRSA's Oversight of the 340B Drug Pricing Program"
- Palmetto Government Benefits Administrator, LLC, Understated Its Medicare Segment Pension Assets (A-07-17-00503)
- Palmetto Government Benefits Administrator, LLC, Generally Claimed Allowable Medicare Pension Costs (A-07-17-00504)
- Palmetto Government Benefits Administrator, LLC, Understated Its Medicare Segment Allocable Pension Costs (A-07-17-00505)
- Updated Corporate Integrity Agreement List
- 07-17-2017
- Updated: Work Plan
- 07-14-2017
- First Coast Service Options, Inc., Understated Its Medicare Segment and Overstated Its Other Segment Allocable Postretirement Benefit Costs (A-07-17-00502)
- First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs (A-07-17-00500)
- First Coast Service Options, Inc., Overstated Its Medicare Segment Postretirement Benefit Assets (A-07-17-00499)
- 07-13-2017
- 2017 National Takedown
- Opioids in Medicare Part D: Concerns about Extreme Use and Questionable Prescribing (OEI-02-17-00250)
- 07-12-2017
- Updated Corporate Integrity Agreement List
- 07-10-2017
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 07-07-2017
- Advisory Opinion 17-02 (regarding a hospital outpatient facility's proposal to reduce or waive, on a non-routine, unadvertised basis, cost-sharing amounts owed by financially needy Medicare beneficiaries for items and services furnished in connection with a clinical research study)
- 07-06-2017
- Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2017 (OEI-05-17-00160)
- Updated Provider Self-Disclosure Settlements
- 07-05-2017
- LEIE Database Updated with June 2017 Exclusions and Reinstatements
- Wisconsin Physicians Service Insurance Corporation Did Not Properly Settle Missouri Medicare Disproportionate Share Hospital Payments (A-07-16-04229)
- Public Summary Report: Readiness of CDC's Strategic National Stockpile Could Be at Risk in Case of a Public Health Emergency (A-04-16-03554)
- Louisiana Complied With the Requirements of the Social Security Act in Its Review of Cases of Credible Allegations of Medicaid Fraud (A-06-16-00010)
June
- 06-29-2017
- Ariel Foundation Against Pediatric AIDS Managed and Expended the President's Emergency Plan for AIDS Relief Funds in Accordance with Award Requirements (A-04-16-04052)
- 06-27-2017
- T-MSIS Data Not Yet Available for Overseeing Medicaid (OEI-05-15-00050)
- 06-21-2017
- Management and Development for Health Did Not Always Manage the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements (A-04-16-04045)
- 06-19-2017
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 06-15-2017
- Updated: Work Plan
- Updated Corporate Integrity Agreement List
- 06-14-2017
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 06-13-2017
- 2016 Performance Data for the Senior Medicare Patrol Project (OEI-02-17-00220)
- Updated Oklahoma State False Claims Act Review
- Updated Corporate Integrity Agreement List
- 06-12-2017
- Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did Not Comply With Federal Requirements (A-05-14-00047)
- Review of Wisconsin Medicaid Managed Care Program Potential Savings With Minimum Medical Loss Ratio (A-05-15-00040)
- Medicare Market Shares of Mail Order Diabetes Test Strips From October Through December 2016 (OEI-04-16-00473)
- 06-09-2017
- Round 2 Competitive Bidding for CPAP/RAD: Disrupted Access Unlikely for Devices, Inconclusive for Supplies (OEI-01-15-00040)
- 06-08-2017
- Eye on Oversight: Abuse in Nursing Homes
- Updated Corporate Integrity Agreement List
- 06-07-2017
- LEIE Database Updated with May 2017 Exclusions and Reinstatements
- 06-05-2017
- Wisconsin State Medicaid Fraud Control Unit: 2016 Onsite Review (OEI-07-16-00240)
- 06-02-2017
- Updated Corporate Integrity Agreement List
- Updated Provider Self-Disclosure Settlements
- 06-01-2017
- Spring 2017 Semiannual Report to Congress
May
- 05-31-2017
- Updated Corporate Integrity Agreement List
- 05-30-2017
- Texas Did Not Always Ensure That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV-E Foster Care Payments Were Recorded and Investigated in Accordance With Federal and State Requirements (A-06-15-00049)
- 05-26-2017
- Minnesota Disbursed Only Part of Its Civil Money Penalty Collections, Limiting Resources To Protect and Improve Care for Nursing Facility Residents (A-05-16-00017)
- Podcast: Combatting Opioid Abuse—OIG's Work Against the Opioid Epidemic
- 05-25-2017
- Asian American and Pacific Islander Heritage Month
- CDC Generally Met Its Inspection Goals for the Federal Select Agent Program; However, Opportunities Exist To Strengthen Oversight (OEI-04-15-00430)
- 05-24-2017
- Updated Corporate Integrity Agreement List
- 05-23-2017
- FY 2018 Congressional Budget Justification
- 05-22-2017
- Medicare Could Save Millions by Eliminating the Lump-Sum Purchase Option for All Power Mobility Devices (A-05-15-00020)
- 05-19-2017
- Medicaid Fraud Control Units Fiscal Year 2016 Annual Report (OEI-09-17-00210)
- Public Summary Report: Virginia Did Not Adequately Secure Its Medicaid Data (A-04-15-05066)
- 05-18-2017
- HHS Did Not Identify and Report Antideficiency Act Violations (A-03-13-03002)
- 05-17-2017
- Compendium of Unimplemented Recommendations
- 05-16-2017
- U.S. Department of Health and Human Services Met Many Requirements of the Improper Payments Information Act of 2002 but Did Not Fully Comply for Fiscal Year 2016 (17-17-52000)
- Medical Ambulance Services, Inc., Claimed Unallowable Reimbursement for Medicare Part B Ambulance Services (A-02-15-01016)
- A Missouri Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Physical Therapy Services (A-07-14-01147)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 05-15-2017
- Kentucky Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries (A-04-15-08044)
- Iowa Did Not Invoice Rebates to Manufacturers for Physician-Administered Drugs of Medicaid Managed-Care Organizations (A-07-16-06065)
- CGS Administrators, LLC, Overstated Its CIGNA Pension Plan Medicare Segment Pension Assets and Understated Medicare's Share of Excess Pension Liabilities (A-07-16-00470)
- CGS Administrators, LLC, Understated Its CIGNA Pension Plan for Certain Former Employees Medicare Segment Pension Assets and Understated Medicare's Share of Excess Pension Assets (A-07-16-00491)
- 05-12-2017
- CGS Administrators, LLC, Generally Claimed Allowable Medicare Pension Costs (A-07-16-00489)
- CGS Administrators, LLC, Did Not Claim Some Allowable Medicare Administrative Contract Postretirement Benefit Costs (A-07-17-00498)
- CGS Administrators, LLC, Claimed Some Unallowable Medicare Administrative Contract Pension Costs (A-07-16-00490)
- 05-09-2017
- Service to the Nation: In the Military and HHS OIG
- Briefing to The Honorable Gus Bilirakis, Subcommittee on Health, Committee on Energy and Commerce, House of Representatives Audit Briefing (A-02-17-02001)
- 05-08-2017
- LEIE Database Updated with April 2017 Exclusions and Reinstatements
- Updated Corporate Integrity Agreement List
- 05-04-2017
- CMS Validated Hospital Inpatient Quality Reporting Program Data, But Should Use Additional Tools to Identify Gaming (OEI-01-15-00320)
- Updated Provider Self-Disclosure Settlements
- 05-03-2017
- Medicare Compliance Review of Mount Sinai Hospital for 2012 and 2013 (A-02-14-01019)
- Updated Corporate Integrity Agreement List
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 05-02-2017
- Testimony of Christi A. Grimm, Chief of Staff, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Energy and Commerce: Subcommittee on Oversight and Investigations: "Combatting Waste, Fraud, and Abuse in Medicaid's Personal Care Services Program"
April
- 04-28-2017
- Economic Opportunity Commission of Nassau County, Inc., Claimed Some Unallowable Hurricane Sandy Disaster Relief Act Funds (A-02-15-02009)
- Illinois Made Correct Medicaid Claim Adjustments (A-05-15-00031)
- Medicare Compliance Review of the University of Arkansas for Medical Sciences Medical Center for 2013 and 2014 (A-06-16-00005)
- Daniel R. Levinson Keynote Address at the 2017 HCCA Compliance Institute
- 04-27-2017
- Indian Health and Human Services Resources
- Updated Corporate Integrity Agreement List
- 04-21-2017
- California Incorrectly Claimed Additional Medicaid Funding Authorized Under the Recovery Act When Reclaiming Overpayments Made to Bankrupt or Out-of-Business Providers (A-09-14-02030)
- Florida Did Not Suspend Medicaid Payments to Some Providers That Had Credible Fraud Allegation Cases in Accordance With the Social Security Act (A-04-14-07046)
- Ohio's and Michigan's Sales and Use Taxes on Medicaid Managed Care Organization Services Do Not Meet Broad-Based Requirement (A-03-16-00200)
- 04-20-2017
- New Jersey Claimed Medicaid Reimbursement for Adult Partial Hospitalization Services That Did Not Comply With Federal and State Requirements (A-02-14-01015)
- 04-19-2017
- Updated Corporate Integrity Agreement List
- 04-11-2017
- Updated Provider Self-Disclosure Settlements
- 04-10-2017
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 04-07-2017
- Ohio Made Incorrect Medicaid Payments to Providers for Full Vials of Herceptin (A-05-15-00032)
- Texas Made Unallowable Medicaid Managed Care Payments for Beneficiaries Assigned More Than One Medicaid Identification Number (A-06-15-00024)
- Updated Corporate Integrity Agreement List
- 04-06-2017
- LEIE Database Updated with March 2017 Exclusions and Reinstatements
- Updated Civil Monetary Penalties and Affirmative Exclusions
March
- 03-30-2017
- Wisconsin Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-16-00014)
- 03-28-2017
- Medicare Compliance Review of Jackson-Madison County General Hospital for Claims Paid From June 1, 2013, Through May 31, 2015 (A-04-15-04042)
- 03-27-2017
- Measuring Compliance Program Effectiveness: A Resource Guide
- 03-24-2017
- Mildmay Uganda Did Not Always Manage the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements (A-04-15-04039)
- Missouri Properly Verified Correction of Deficiencies Identified During Surveys of Nursing Homes (A-07-16-03217)
- 03-22-2017
- Mississippi Claimed Millions in Unallowable School-Based Medicaid Administrative Costs (A-04-15-00103)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 03-20-2017
- Alta Bates Medical Center Inaccurately Reported Wage Data, Resulting in Medicare Overpayments Audit (A-09-14-02035)
- Cleveland Clinic Lerner College of Medicine Inappropriately Drew Down Hurricane Sandy Disaster Relief Act Funds and Did Not Always Implement Effective Internal Controls Audit (A-02-15-02011)
- 03-17-2017
- Data Inadequacies Undermine CMS's Oversight of the Inconsistency Resolution Process for the Federal Marketplace (OEI-01-14-00620)
- 03-15-2017
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 03-14-2017
- Nantucket Cottage Hospital Did Not Accurately Report Certain Wage Data, Resulting in Overpayments to Massachusetts Hospitals (A-01-15-00502)
- Public Summary Report: Information Technology Control Weaknesses Found at the Commonwealth of Massachusetts' Medicaid Management Information System (A-06-15-00057)
- Hospitals Nationwide Generally Did Not Comply With Medicare Requirements for Billing Outpatient Right Heart Catheterizations With Heart Biopsies (A-01-13-00511)
- 03-13-2017
- Medicare Compliance Review of University of Florida Health Jacksonville for 2013 and 2014 (A-04-15-07057)
- Blue Cross Blue Shield Association Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2011 Through 2015 (A-07-17-00497)
- Blue Cross Blue Shield Association Overstated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Assets as of September 30, 2015 (A-07-17-00496)
- 03-10-2017
- Advisory Opinion 17-01 (regarding a hospital system's proposal to provide free or reduced-cost lodging and meals to certain financially needy patients)
- Modification of Advisory Opinion 02-1 (modifies Advisory Opinion 02-1, which concerned a non-profit, tax-exempt, charitable organization's providing cost-sharing and premium assistance to financially needy patients diagnosed with specific chronic illnesses and rare disorders, to reflect guidance issued on May 21, 2014 in the Supplemental Special Advisory Bulletin regarding Independent Charity Patient Assistance Programs.)
- 03-09-2017
- Testimony of Daniel R. Levinson, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Appropriations: Subcommittee on Labor, Health and Human Services, Education, and Related Agencies: "Management Challenges at the Departments of Labor, Health and Human Services, and Education and the Social Security Administration"
- Review of Blue Cross Blue Shield Association Final Administrative Cost Proposals for Fiscal Years 2010 Through 2015 (A-05-15-00056)
- Medicare Contractors' Payments to Providers for Hospital Outpatient Dental Services Generally Did Not Comply With Medicare Requirements (A-06-16-05003)
- Nebraska Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Transportation Program (A-07-16-03209)
- 03-08-2017
- Medicare Compliance Review of Mayo Clinic Florida for 2013 and 2014 (A-04-15-07058)
- New York Improperly Claimed Federal Medicaid Reimbursement for Partial Hospitalization Services (A-02-16-01013)
- Updated Provider Self-Disclosure Settlements
- 03-07-2017
- LEIE Database Updated with February 2017 Exclusions and Reinstatements
- Updated Corporate Integrity Agreement List
- 03-06-2017
- Podcast: Medicaid Fraud Control Units
- Medicaid Fraud Control Units Statistical Data for Fiscal Year 2016
- 03-03-2017
- Fraud Alert: HHS OIG Hotline Telephone Number Used in Scam
- Video Series Eye on Oversight: Medical Identity Theft
- 03-01-2017
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2016 (A-18-16-30350)
February
- 02-24-2017
- Updated Corporate Integrity Agreement List: 1 CIA Added
- 02-23-2017
- New Jersey Claimed Some Unallowable Costs Under a Hurricane Sandy Disaster Relief Act Grant (A-02-15-02005)
- 02-17-2017
- Drug-Pricing and Reimbursement Portfolio
- 02-16-2017
- Newark Preschool Council, Inc., Did Not Always Comply With Head Start Requirements (A-02-14-02024)
- 02-15-2017
- New York Claimed Medicaid Reimbursement for Unallowable Dental Services Billed by a Dentist Based in Westchester County (A-02-13-01033)
- New York Claimed Medicaid Reimbursement for Unallowable Dental Services Billed by a Dentist Based in Queens (A-02-13-01034)
- 02-14-2017
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 02-13-2017
- The University of California at Riverside's Pilot Payroll Certification System Did Not Provide Accountability Over Payroll Charges to Federal Awards (A-04-13-01026)
- 02-08-2017
- Puerto Rico's Controls for Its Child Care and Development Program Claims Were Not Effective (A-02-13-02005)
- Updated Corporate Integrity Agreement List: 1 CIA Added
- Updated Provider Self-Disclosure Settlements and CIA Reportable Event Settlements
- 02-07-2017
- LEIE Database Updated with January 2017 Exclusions and Reinstatements
- Updated Corporate Integrity Agreement List: 7 CIAs Closed
- 02-06-2017
- HHS OIG's Podcast: Voluntary Tribal Compliance Agreement
- Medicare Market Shares of Mail Order Diabetes Test Strips From July Through September 2016 (OEI-04-16-00471)
- 02-03-2017
- CDC Awarded Selected Ebola Funds for International Response Activities in Accordance With Applicable Laws, Regulations, and Departmental Guidance (A-04-16-03568)
- Kentucky Misallocated Millions to Establishment Grants for a Health Insurance Marketplace (A-04-14-07050)
- Vidant Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition (A-03-15-00011)
- 02-02-2017
- New Jersey Should Strengthen Hurricane Sandy Social Services Block Grant Internal Controls (A-02-14-02010)
- 02-01-2017
- Fall Health Care Fraud and Abuse Legal Internship Program
January
- 01-31-2017
- Testimony of Ann Maxwell, Assistant Inspector General, Office of Inspector General, U.S. Department of Health and Human Services: Medicaid Oversight: House Committee on Energy and Commerce: Subcommittee on Oversight and Investigations: "Existing Problems and Ways to Strengthen the Program"
- Testimony of Vicki L. Robinson, Senior Counselor for Policy, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Oversight and Government Reform: Subcommittee on Health Care, Benefits, and Administrative Rules: "Fraud, Waste, and Abuse Under the Affordable Care Act"
- 01-30-2017
- Updated Corporate Integrity Agreement List: 1 CIAs Added
- 01-26-2017
- Review of California Medicaid Managed-Care Program Potential Savings With Minimum Medical Loss Ratio (A-09-15-02025)
- 01-25-2017
- Updated Corporate Integrity Agreement List: 2 CIAs Added
- 01-23-2017
- Excluded and Unlicensed New Jersey Dentist Who Assumed Identity of Another Dentist Agrees to Settlement of $1.1 Million and 50-Year Exclusion to Resolve Civil Monetary Penalty Case
- Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2015 (A-18-16-30300)
- Updated Corporate Integrity Agreement List: 1 CIA Added
- 01-19-2017
- Independent Attestation Review: Indian Health Service Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00351)
- Independent Attestation Review: National Institutes of Health Fiscal Year 2016 Detailed Accounting Submissions and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00352)
- Independent Attestation Review: Substance Abuse and Mental Health Services Administration Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00353)
- Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00354)
- Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00355)
- 01-18-2017
- FY 2016 Health Care Fraud and Abuse Control Program Report
- Video Series Eye on Oversight: Exclusions
- California Improperly Claimed Federal Medicaid Reimbursement for Certain Nonemergency Services (A-09-15-02020)
- Northside Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition (A-03-15-00012)
- A Southern California Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Therapy Services (A-09-15-02015)
- Updated Civil Monetary Penalties and Affirmative Exclusions
- 01-13-2017
- Updated Provider Self-Disclosure Settlements
- 01-12-2017
- Louisiana Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Program (A-06-15-00019)
- Delaware Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-03-15-00202)
- 01-11-2017
- Final Rule: Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General's Exclusion Authorities
- 01-10-2017
- Podcast: December 2016 OIG Monthly Update
- 01-09-2017
- Colorado Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-07-14-06050)
- Medicare Compliance Review of NorthShore University HealthSystem for 2013 and 2014 (A-05-15-00044)
- Updated Corporate Integrity Agreement List: 1 CIA Added
- 01-06-2017
- LEIE Database Updated with December 2016 Exclusions and Reinstatements
- Updated Corporate Integrity Agreement List: CIAs Added & Closed
- 01-05-2017
- High-Price Drugs Are Increasing Federal Payments for Medicare Part D Catastrophic Coverage (OEI-02-16-00270)
- Virginia Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-03-15-00201)
- Medicare Compliance Review of Abbott Northwestern Hospital for 2013 and 2014 (A-05-15-00043)
- 01-03-2017
- Updated Corporate Integrity Agreement List: 5 CIAs Added
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