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What's New

See also: Archive

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 Desafíos 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

July

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

June

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 AO 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. )

May

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.)

April

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

March

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

February

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

January

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

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