Advisory Opinion 14-02
(concerning the use of "preferred hospital" networks as part of certain Medicare Supplemental Health Insurance ("Medigap") policies.)

Drug Testing Company to Pay $5 Million Civil Money Penalty Settlement

Medicus Laboratories Added to Corporate Integrity Agreement List

02-19-2014

Podcast: Expanding the DRG Window

Medicare and Beneficiaries Could Realize Substantial Savings If the DRG Window Were Expanded (OEI-05-12-00480)

02-14-2014

Yousef Kurdy added to Most Wanted Fugitives List

Pleaded Guilty: Randy Lee Essary

Compliance Review of Lowell General Hospital's Methuen Dialysis Facility (A-01-12-00517)

South Carolina Medicaid Overpaid Hospitals for Some Inpatient Services That Medicare Paid (A-04-11-06145)

02-12-2014

New York State Made Unallowable Medicaid Fee-for-Service Payments for Beneficiaries Also Enrolled in Medicaid Managed Care (A-02-12-01007)

Medicare Compliance Review of UMass Memorial Medical Center for Calendar Years 2010 and 2011 (A-01-13-00503)

The Medicare Contractors for Jurisdiction 12 Overpaid Providers for Selected Outpatient Drugs (A-03-13-00012)

The Medicare Contractors for Jurisdiction 11 Overpaid Providers for Selected Outpatient Drugs (A-03-13-00011)

Medicare Compliance Review of Baylor All Saints Medical Center at Fort Worth for Calendar Years 2010 and 2011 (A-06-12-00030)

Kentucky Did Not Pay Some Line Items on Medicaid Claims in Accordance With Its Medicaid National Correct Coding Initiative Methodologies (A-04-13-06166)

Review of Douglas Consulting and Computer Services, Inc., Claimed Costs for Calendar Years 2008 Through 2011 (A-03-12-03302)

02-11-2014

Mercy Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00033)

Utah Did Not Properly Pay Some Medicare Deductibles and Coinsurance (A-07-13-03191)

TrailBlazer Claimed Medicare Part B Administrative Costs in Accordance With Federal Requirements (A-06-13-00016)

The Minnesota Medicaid Program Could Significantly Lower Payment Rates for Selected Durable Medical Equipment and Supplies (A-05-13-00015)

02-10-2014

Medicare Improperly Paid Millions of Dollars for Prescription Drugs Provided to Incarcerated Beneficiaries During 2006 Through 2010 (A-07-12-06035)

Missouri Did Not Always Correctly Claim Costs for Medicaid Family Planning Drugs for Calendar Years 2009 and 2010 (A-07-12-01118)

The Medicare Contractors for Jurisdiction E Overpaid Providers for Selected Outpatient Drugs (A-09-13-02009)

The Medicare Contractor for Jurisdiction F Overpaid Providers for Selected Outpatient Drugs (A-09-13-02003)

Christus Saint Vincent Regional Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00035)

02-07-2014

LEIE Database Updated with January 2014 Exclusions and Reinstatements

Medicare Compliance Review of Medical University of South Carolina for the Period January 1, 2011, Through June 30, 2012 (A-04-13-03075)

02-06-2014

OIG Outlook 2014

02-05-2014

Podcast: Contract Pharmacy Arrangements in the 340B Drug Discount Program

Contract Pharmacy Arrangements in the 340B Program (OEI-05-13-00431)

Freedom of Information Act (FOIA) Annual Report FY 2013

Updated Corporate Integrity Agreement List: CIAs Closed

02-03-2014

Podcast: January OIG Monthly Update

Captured Fugitive: Hector Hernandez

January

01-31-2014: OIG Releases 2014 Work Plan; 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-04-14-06173); Disclosure and Accounting of Protected Records by CMS Between 2006 and 2011 (OEI-09-11-00430)
01-30-2014: Podcast: World Trade Center Health Program; World Trade Center Health Program: CDC Should Strengthen Efforts To Monitor and Evaluate Clinic Compliance With Contract Terms (A-02-11-02003); Progress in Electronic Health Record Implementation Through HRSA Grants to Health Center Controlled Networks (OEI-09-11-00380); Michigan State Medicaid Fraud Control Unit: 2013 Onsite Review (OEI-09-13-00070)
01-27-2014: State Medicaid Program Efforts to Control Costs for Disposable Incontinence Supplies (OEI-07-12-00710)
01-24-2014: Over Four Million Medicare Summary Notices Mailed to Beneficiaries Were Not Delivered in 2012 (OEI-03-12-00600)
01-23-2014: Abubakar Durrani added to Most Wanted Fugitives List
01-22-2014: Medicaid Fraud Control Units 2014 Budget Calendar; Korban, Elie H., M.D. Added to Corporate Integrity Agreement List; Advisory Opinion 14-01
(concerning contracts under which a placement agency is compensated for referring new residents to senior communities where they may eventually receive services paid for by Federal health care programs.)
01-17-2014: Jersey City, New Jersey, Did Not Always Comply With Early Retiree Reinsurance Program Requirements (A-05-12-00039); Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2011 (A-18-13-30100); Medicare Compliance Review of Memorial Hospital for Calendar Years 2010 and 2011 (A-07-13-01124); Medicare Compliance Review of Morton Hospital for Calendar Years 2010 and 2011 (A-01-13-00500)
01-16-2014: Medicare Claims Administration Contractors' Error Rate Reduction Plans (OEI-09-12-00090); Podcast: Review of Maryland's Federal Medicaid Withdrawals
01-15-2014: Microport Orthopedic, Inc. Added to Corporate Integrity Agreement List
01-13-2014: Medicare Payments for Vacuum Erection Systems Are More Than Twice as Much as the Amounts Paid for the Same or Similar Devices by Non-Medicare Payers (A-07-12-05024); Sharma, Ravi, M.D. Added to Corporate Integrity Agreement List
01-10-2014: Kentucky Did Not Correctly Calculate Payment Rates for Private Facilities or Report Cost Settlement Adjustments to CMS (A-04-12-08018); Noridian Healthcare Solutions, LLC, Overstated Its Allocable Pension Costs for Calendar Years 2006 Through 2010 (A-07-13-00419); Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Pension Costs for Fiscal Years 2006 Through 2010 (A-07-13-00418); Medicare Compliance Review of Heartland Regional Medical Center for Calendar Years 2010 and 2011 (A-07-12-01120); Texas' Experience Rebate Provision in Managed Care Contracts Were Administered in Accordance with Federal, State, and Contractual Requirements (A-06-13-00002)
01-09-2014: Podcast: Medicare Administrative Contractors' Performance; Medicare Administrative Contractors' Performance (OEI-03-11-00740); Pennsylvania Generally Claimed Allowable Community Services Block Grant Recovery Act Costs for Community Action Program of Lancaster County (A-03-12-00250); Medicare Could Have Saved Millions if Organ Procurement Organizations Had Correctly Reported Procurement of Double Lungs as Two Organs (A-09-12-02085); Most of New Jersey's Claims for Medicaid Supported Employment Services Were Unallowable (A-02-12-01009); CMS Should Improve Oversight for the Transfer of True Out-of-Pocket Costs Between Part D Plans (A-05-12-00053)
01-08-2014: Podcast: Fraud Safeguards in Electronic Health Records; CMS and Its Contractors Have Adopted Few Program Integrity Practices To Address Vulnerabilities in EHRs (OEI-01-11-00571); Local Coverage Determinations Create Inconsistency in Medicare Coverage (OEI-01-11-00500); LEIE Database Updated with December 2013 Exclusions and Reinstatements
01-07-2014: Diabetes Durable Medical Equipment Supplier, Telemarketing Company, and Their Owner-Executives Agree to Exclusions in Settlements with OIG
01-06-2014: Podcast: December 2013 OIG Update; Updated Corporate Integrity Agreement List: 1 CIA Closed

December

12-27-2013: Vermont Medicaid Fraud Control Unit: 2013 Onsite Review (OEI-02-13-00360); Final Rule: Medicare and State Health Care Programs: Fraud and Abuse; Electronic Health Records Safe Harbor Under the Anti-Kickback Statute; Solicitation of New Safe Harbors and Special Fraud Alerts
12-23-2013: Fall 2013 Semiannual Report; Services Provided at Critical Access Hospitals in 2011 Report (OEI-05-12-00081); The ESRD Beneficiary Grievance Process Report (OEI-01-11-00550); Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Pension Assets as of January 1, 2011 (A-07-13-00417); Colorado Did Not Properly Pay Some Medicare Part B Deductibles and Coinsurance (A-07-13-03189); Georgia Did Not Pay Some Line Items on Medicaid Claims in Accordance With Its Medicaid National Correct Coding Initiative Methodologies (A-04-12-06159); Hawaii Did Not Comply With Some Provisions of the QUEST Expanded Medicaid Demonstration Project When Determining Eligibility for Federal Reimbursement of Uncompensated Care Costs (A-09-12-02084)
12-20-2013: Podcast: Reviews of Clinicians Tied to High Cumulative Payments Could Strengthen Medicare Integrity Efforts; Reviews of Clinicians Associated With High Cumulative Payments Could Improve Medicare Program Integrity Efforts (A-01-11-00511); Maryland Withdrew Excessive Federal Medicaid Funds for Fiscal Years 2009 Through 2011 (A-06-12-00051); Delegation of Authority
12-18-2013: Spotlight On Fighting Fraud at Community Mental Health Centers
12-17-2013: 2013 Top Management & Performance Challenges
12-13-2013: Updated Corporate Integrity Agreement List: 3 CIAs Closed
12-10-2013: LEIE Database Updated with November 2013 Exclusions and Reinstatements; Updated Corporate Integrity Agreement List: Three New CIAs Added; Not All Recommended Fraud Safeguards Have Been Implemented in Hospital EHR Technology (OEI-01-11-00570); Medicare Compliance Review of St. Vincent's Medical Center for Calendar Years 2009 and 2010 (A-04-12-08013); Medicare Compliance Review of St. Elizabeth's Medical Center for Calendar Years 2010 and 2011 (A-01-12-00528); The Council on Rural Service Programs, Inc., Claimed Unallowable Head Start Costs (A-05-12-00089)
12-05-2013: Noridian Healthcare Solutions, LLC, Inappropriately Paid Hospitals' Medicare Claims Subject to the Postacute Care Transfer Policy in Jurisdiction 2 (A-09-13-02035)
12-04-2013: Medicare Compliance Review of JFK Medical Center for Calendar Years 2009 and 2010 (A-04-12-07032); The Office for Civil Rights Did Not Meet All Federal Requirements in Its Oversight and Enforcement of the Health Insurance Portability and Accountability Act Security Rule (A-04-11-05025)
12-03-2013: November 2013 OIG Monthly Update
12-02-2013: Advisory Opinion 13-19
(concerning patient assistance programs that provide funding for premium assistance and certain other medical expenses to [disease redacted] patients in financial need.); Maryland Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-03-12-00200)

November

11-29-2013

Podcast: Contractors Overpaid Millions to Providers for Herceptin

Medicare Contractors Nationwide Overpaid Millions to Providers for Full Vials of Herceptin (A-05-13-00024)

Connecticut Often Did Not Comply With Federal Adoption Assistance Requirements (A-01-12-02507)

11-27-2013

Advisory Opinion 13-18
(concerning an ambulance supplier's response to a request for proposals for the provision of all emergency ambulance services.)

Medicare Compliance Review of Mercy Medical Center in Mason City for Calendar Years 2010 and 2011 (A-07-12-05030)

Diep Chiropractic Wellness, Inc., Received Unallowable Medicare Payments for Chiropractic Services (A-09-12-02072)

New York Claimed Some Unallowable Costs for Assistive Technology Services Under the State's Developmental Disabilities Waiver Program (A-02-10-01039)

Medicare Compliance Review of Mercy Medical Center in Des Moines for Calendar Years 2009 and 2010 (A-07-12-05028)

Parkland Health and Hospital System Claimed Unallowable Medicare Reimbursement for Hospital Outpatient Dental Services (A-06-13-00003)

11-25-2013

November 1, 2013 Amendment to the CIA Synthes, Inc.

11-22-2013

Captured Fugitive Update: Francisco Chavez Pleads Guilty

Arkansas Properly Reported the Affordable Care Act Portion of Medicaid Drug Rebates (A-06-13-00034)

Medicare Compliance Review of University of Utah Hospital for Calendar Years 2009 and 2010 (A-07-12-01107)

Oregon Generally Claimed Federal Medicaid Reimbursement for Money Follows the Person Program Expenditures in Compliance With Federal and State Requirements but Internal Controls Should Be Strengthened (A-09-12-02049)

11-21-2013

OIG Strategic Plan 2014-2018

Advisory Opinion 13-17
(concerning a proposal to use tax revenues to cover out-of-pocket amounts owed for county-operated emergency ambulance services received by non-residents.)

11-20-2013

Lynch Ambulance/Filyn Corporation, and The Vision Center/Sabine Optical Laboratories, Inc. Added to Corporate Integrity Agreement List

11-19-2013

Podcast: Nursing Home Resident Hospitalizations Merit Additional Monitoring

Medicare Nursing Home Resident Hospitalization Rates Merit Additional Monitoring (OEI-06-11-00040)

11-18-2013

Ohio Exceeded the 5-Percent Limit for Claiming Child Care Development Fund Administrative Expenditures (A-05-13-00014)

11-14-2013

Podcast: Federal News Radio: Incorporating Risk Management and Assessment to Maximize Resources and Results

Medicare Hospital Outlier Payments Warrant Increased Scrutiny (OEI-06-10-00520)

Biospecimen Research: Meeting Basic Human Subjects Protection Requirements and Communicating Informational (OEI-01-11-00520)

Advisory Opinion 13-16
(concerning a health insurer's proposal to pay the Medicare Part B premium costs for Medicare-eligible individuals with End-Stage Renal Disease who are enrolled in a group health plan offered by the insurer and receiving dialysis services.)

11-13-2013

State and CMS Oversight of the Medicaid Managed Care Credentialing Process (OEI-09-10-00270)

State False Claim Act Reviews Updated: Minnesota and Delaware

11-12-2013

Advisory Opinion 13-15
(concerning an anesthesia services provider's proposal to contract with a psychiatry practice group to provide anesthesia services in connection with electroconvulsive therapy procedures at a hospital.)

11-08-2013

Updated Civil Monetary Penalties:

11-07-2013

Closed Corporate Integrity Agreement: Walgreen Co. and First Amendment to the CIA

August and September Recovery Act Oversight Reports Posted

11-06-2013

LEIE Database Updated with October 2013 Exclusions and Reinstatements

Advanced Cardiology Center, Choudry, Mubashar, M.D., Ijaz, Moshin, M.D., Lal, Pankaj, M.D. Added to Corporate Integrity Agreement List

11-05-2013

Podcast: Child Care and Development Fund: Monitoring of Licensed Child Care Providers

Child Care and Development Fund: Monitoring of Licensed Child Care Providers (OEI-07-10-00230)

11-04-2013

Podcast: October OIG Monthly Update

Johnson & Johnson Added to Corporate Integrity Agreement List

11-01-2013

National Government Services, Inc., Understated Its Medicare Segment Pension Assets as of January 1, 2010 (A-07-13-00408)

National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs for Fiscal Years 2003 Through 2006 (A-07-13-00409)

Costs Claimed by Johns Hopkins Bayview Medical Center Under National Institutes of Health Contract Number HHSN292200900002C Were Generally Allowable. (A-03-12-03300)

October

10-31-2013

Podcast: Medicare Payments Made on Behalf of Deceased Beneficiaries in 2011

Medicare Payments Made on Behalf of Deceased Beneficiaries in 2011 (OEI-04-12-00130)

Medicare Improperly Paid Millions of Dollars for Prescription Drugs Provided to Unlawfully Present Beneficiaries During 2009 Through 2011 (A-07-12-06038)

National Government Services, Inc., Paid Unallowable Lower Limb Prosthetics Claims (A-07-13-05039)

Medicare Compliance Review of Mary Washington Hospital for Calendar Years 2009 Through 2011 (A-03-12-06106)

10-29-2013

Virginia Properly Obligated and Liquidated Most Targeted Funds Under the Child Care and Development Fund Program (A-03-12-00251)

Colorado Improperly Claimed Some Medicaid Costs for Hospice Services Provided by Evercare Hospice & Palliative Care (A-07-13-04204)

Medicare Compliance Review Of MedStar Washington Hospital Center (A-03-12-06103)

Louisiana Improperly Claimed Some Child Care and Development Fund Targeted Funds (A-06-12-00057)

Wayne State University Claimed Allowable Costs Under National Institutes of Health Grant No. R01NS039860 (A-05-13-00041)

State False Claim Act Reviews Updated: Colorado, Montana, and Rhode Island

10-25-2013

New York Improperly Claimed Medicaid Reimbursement for Orthodontic Services to Beneficiaries in New York City (A-02-11-01003)

Economic Opportunity Commission of Nassau County, Inc., Claimed Some Unallowable Head Start Costs (A-02-12-02003)

Information Security Weaknesses Pose Risk to Operations and the Mission of the Substance Abuse and Mental Health Services Administration (SAMHSA) (A-18-12-30420)

Exclusion Authority FAQ Update

10-24-2013

Spinal Devices Supplied by Physician-Owned Distributors: Overview of Prevalence and Use (OEI-01-11-00660)

New York State Claimed Unallowable Community Services Block Grant Recovery Act Costs for Action for a Better Community, Inc. (A-02-11-02020)

10-23-2013

Neighborhood Centers, Inc., Claimed Unallowable Head Start Costs (A-06-11-00055)

Nevada State Medicaid Fraud Control Unit: 2012 Onsite Review (OEI-09-12-00450)

10-22-2013

Five Fugitives Added to OIG's Most Wanted List

Advisory Opinion 13-14
(concerning a proposal whereby a county would not bill bona fide county residents otherwise applicable cost-sharing amounts due in connection with emergency ambulance services provided by the local fire department and a volunteer rescue company, but would instead use tax revenues to cover the unpaid cost-sharing amounts.)

10-21-2013

Podcast: Family Day Care Home Providers and State Health and Safety License Requirements

10-18-2013

2014 Spring OIG Legal Extern Position

Montana State Medicaid Fraud Control Unit: 2012 Onsite Review (OEI-09-12-00700)

10-15-2013

Advisory Opinion 13-13
(concerning a non-profit community health services organization's proposal to begin billing Medicaid for dental services provided to its patients, while continuing to provide free dental services to uninsured and underinsured financially needy children.)

Scott Ellender, O.D. Added to Corporate Integrity Agreement List

HealthNow New York, Inc., Did Not Claim Some Allowable Medicare Part B Pension Costs for Fiscal Years 2007 Through 2009 (A-07-13-00426)

HealthNow New York, Inc., Understated Its Medicare Part B Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of January 1, 2009 (A-07-13-00425)

Medicare Compliance Review of UPMC Presbyterian Shadyside for Calendar Years 2008 Through 2011 (A-03-12-06105)

10-10-2013

Medicare Compliance Review of University of Wisconsin Hospital and Clinics for Calendar Years 2008 Through 2010 (A-05-12-00030)

10-09-2013

Questionable Billing for Polysomnography Services (OEI-05-12-00340)

Updated Civil Monetary Penalties:

10-08-2013

LEIE Database Updated with September 2013 Exclusions and Reinstatements

Medicare Compliance Review of University of Miami Hospital (A-04-12-07033)

10-07-2013

West Virginia State Medicaid Fraud Control Unit: 2013 Onsite Review (OEI-07-13-00080)

10-04-2013

Updated Corporate Integrity Agreement List: CIAs Closed

10-03-2013

Podcast: First Level of the Medicare Appeals Process

The First Level of the Medicare Appeals Process, 2008-2012: Volume, Outcomes, and Timeliness (OEI-01-12-00150)

Indiana Claimed Medicaid Reimbursement for High-Dollar Inpatient Services That Were Unallowable (A-05-11-00040)

10-01-2013

Connecticut Family Day Care Home Providers Did Not Always Comply With State Health and Safety Licensing Requirements (A-01-12-02504)

New York State Improperly Claimed Medicaid Reimbursement for Some Home Health Services Claims Submitted by Certified Home Health Agencies (A-02-11-01008)

Oklahoma Complied With the Federal Medicaid Requirements for Billing Manufacturers for Rebates for Physician-Administered Drugs (A-06-12-00059)

September

09-30-2013

Podcast: September OIG Monthly Update

09-25-2013

Utilization of Medicare Ambulance Transports, 2002-2011 (OEI-09-12-00350)

Medicare Incorrectly Paid Hospitals for Beneficiaries Who Had Not Received 96 or More Hours of Mechanical Ventilation (A-09-12-02066)

Illinois Did Not Always Properly Claim Medicaid Reimbursement for Hospice Claims (A-05-12-00029)

09-24-2013

New Widget: Beware of Health Insurance Marketplace Scams

09-23-2013

Captured Fugitive: Peter Pedro Egede

Arkansas State Medicaid Fraud Control Unit: 2013 Onsite Review (OEI-06-12-00720)

09-20-2013

FDA's Clearance of Medical Devices Through the 510(k) Process (OEI-04-10-00480)

Bravo Health Pennsylvania, Inc. (Contract H3949), Submitted Many Diagnoses to the Centers for Medicare & Medicaid Services That Did Not Comply With Federal Requirements for Calendar Year 2007 (A-03-09-00003)

Wisconsin Improperly Claimed Federal Medicaid Reimbursement for Most Residential Care Center Payments (A-05-07-00036)

Medicaid Hospice General Inpatient Payments to Home and Hospice Care of Rhode Island Did Not Always Meet Federal and State Requirements (A-01-13-00002)

Tallahassee Memorial HealthCare, Inc., Submitted Incomplete Quality Measure Data to CMS (A-04-11-08002)

Wayne State University Claimed Allowable Costs Under National Institutes of Health Grant No. R01NS064976 (A-05-13-00040)

09-19-2013

Podcast: Transformed Medicaid Statistical Information System

Early Outcomes Show Limited Progress for the Transformed Medicaid Statistical Information System (OEI-05-12-00610)

New Jersey Medicaid Fraud Control Unit: 2013 Onsite Review (OEI-02-13-00020)

Updated Corporate Integrity Agreement List: Three New CIAs Added

09-18-2013

LEIE Database Updated with August 2013 Exclusions and Reinstatements

Consumer Alert: Consumer Fraud in the Health Insurance Marketplace

Podcast: Consumer Fraud in the Health Insurance Marketplace

09-16-2013

Captured Fugitive: Carmen Gonzalez

09-13-2013

Maryland Claimed Costs for Unallowable Room and Board and Other Residential Habilitation Costs Under Its Community Pathways Waiver Program (A-03-12-00203)

09-12-2013

July Recovery Act Oversight Monthly Report Posted

Updated Civil Monetary Penalties:

09-11-2013

Testimony of Kay Daly, Assistant Inspector General for Audit Services, before the House Committee on Homeland Security, Subcommittee on Cybersecurity, Infrastructure Protection and Security Technologies - "The Threat to Americans' Personal Information: A Look Into the Security and Reliability of the Health Exchange Data Hub"

Medicare Compliance Review of Sanford Medical Center in Fargo for Calendar Years 2010 and 2011 (A-07-12-05031)

New Jersey Medicaid Program Could Achieve Savings by Reducing Home Blood-Glucose Test Strip Prices (A-02-12-01010)

New York Claimed Hospital-Based Continuing Day Treatment Services That Were Not in Compliance With Federal and State Requirements (A-02-11-01038)

09-10-2013

Medicare Could Collect Billions If Pharmaceutical Manufacturers Were Required To Pay Rebates for Part B Drugs (OEI-12-12-00260)

Medicare Compliance Review of Southcoast Hospitals Group for Calendar Years 2010 and 2011 (A-01-12-00523)

Medicare Compliance Review of Tulane Medical Center of New Orleans for Calendar Years 2010 and 2011 (A-06-12-00034)

Medicare Compliance Review of St. Joseph Regional Health Center for Calendar Years 2009 and 2010 (A-06-12-00029)

Salary and Nonsalary Costs Claimed by the University of Texas Southwestern Medical Center Were Allowable (A-06-11-00018)

Durable Medical Equipment Claims Paid by Noridian Healthcare Solutions, LLC, Did Not Always Meet the Requirements of the Local Coverage Determination for Lower Limb Prostheses (A-07-12-05035)

National Health Laboratory Service Did Not Always Manage President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (A-05-12-00024)

The South African National Department of Health Did Not Always Manage President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (A-05-12-00022)

Aurum Institute for Health Research Did Not Always Manage President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (A-05-12-00021)

Massachusetts Medicaid Payments to Golden Living Centers Did Not Comply with Federal and State Requirements (A-01-13-00007)

09-09-2013

Imagimed, LLC Added to Corporate Integrity Agreement List

09-06-2013

Medicaid DMEPOS Costs May be Exceeding Medicare Costs in Competitive Bidding Areas (OEI-06-13-00470)

09-04-2013

Podcast: Recovery Audit Contractors and Improper Payments

Medicare Recovery Audit Contractors and CMS's Actions To Address Improper Payments, Referrals of Potential Fraud, and Performance (OEI-04-11-00680)

Updated Corporate Integrity Agreement List: CIAs Closed

09-03-2013

OIG Most Wanted Fugitives Update:

Captured: Francisco Chavez
Newly Added: Marina Nazarova

Podcast: OIG Monthly Update

August

08-30-2013

GAO Forum Highlights Report: Data Analytics For Oversight and Law Enforcement

Medicaid Drug Pricing in State Maximum Allowable Cost Programs (OEI-03-11-00640)

Frequency of Medicare Recertification Surveys for Hospices Is Unimproved (OEI-06-13-00130)

08-29-2013

Dixan Barcelo and Alfredo Barcelo Added to Most Wanted Fugitives List

08-28-2013

Alabama Received Millions in Unallowable Performance Bonus Payments Under the Children's Health Insurance Program Reauthorization Act (A-04-12-08014)

08-27-2013

Inappropriate and Questionable Medicare Billing for Diabetes Test Strips (OEI-04-11-00330)

Advisory Opinion 13-12
(concerning use of a "preferred hospital" network as part of certain Medicare Supplemental Health Insurance ("Medigap") policies.)

08-23-2013

Park Avenue Medical Associates, P.C. Added to Corporate Integrity Agreement List

08-21-2013

Advisory Opinion 13-11
(concerning two proposed arrangements involving the provision of emergency medical services for a township.)

Work Plan Update

08-20-2013

Barrio Comprehensive Family Health Care Center, Inc., Did Not Always Follow Federal Regulations (A-06-11-00067)

08-16-2013

Advisory Opinion 13-10
(concerning a proposal to contract with hospitals to provide services to patients with certain diagnoses following hospital discharge with the goal of reducing preventable hospital readmissions.)

Durable Medical Equipment Claims Paid by National Heritage Insurance Company, Inc., Did Not Always Meet the Requirements of the Local Coverage Determination for Lower Limb Prostheses (A-07-13-05040)

Washington State Claimed a Small Amount of Unallowable Medicaid Reimbursement for Home Health Services That Exceeded the Maximum Allowable Number of Reimbursable Visits (A-09-12-02056)

Palmetto GBA Claimed Substantially Allowable Costs on Its Part B Final Administrative Cost Proposals for Fiscal Years 2010 and 2011 (A-04-13-04008)

New Jersey Did Not Always Claim Medicaid Reimbursement for Medicare Part B Premiums in Accordance with Federal Requirements (A-02-10-01025)

New York Complied With Federal Requirements to Report Medicaid Overpayment Collections for the Quarter Ended September 30, 2011 (A-02-12-01020)

Not All Community Services Block Grant Costs Claimed on Behalf of the Carbon County Community Action Committee for the Period October 1, 2008, Through September 30, 2010, Were Allowable (A-07-11-02766)

08-15-2013

Most Critical Access Hospitals Would Not Meet the Location Requirements If Required To Re-enroll in Medicare (OEI-05-12-00080)

Podcast: Critical Access Hospital Designations

08-14-2013

Podcast: Federal News Radio: CMS's Implementation of the Data Services Hub

08-12-2013

2014 Summer OIG Law Clerk Program

National Government Services Claimed Allowable Administrative Costs for Fiscal Years 2008 and 2009 under Medicare Contract 00130 (A-05-12-00037)

Medicare Compliance Review of the Hospital of the University of Pennsylvania for Calendar Years 2008 Through 2011 (A-03-12-06104)

08-08-2013

LEIE Database Updated with July 2013 Exclusions and Reinstatements

Hernando-Pasco Hospice Added to Corporate Integrity Agreement List

08-07-2013

June Recovery Act Oversight Monthly Report Posted

08-06-2013

2013 HHS OIG Recovery Act Implementation and Work Plan

Medicare Could Save Millions by Strengthening Billing Requirements for Canceled Elective Surgeries (A-01-12-00509)

08-05-2013

Observations Noted During the OIG Review of CMS's Implementation of the Health Insurance Exchange-Data Services Hub (A-18-13-30070)

Podcast: OIG Monthly Update

Updated Civil Monetary Penalties:

08-02-2013

State False Claims Act Review Letters Updated: Massachusetts and Tennessee

Updated Corporate Integrity Agreement List: CIAs Closed

08-01-2013

Spotlight On Bad Bargains for Federal Health Programs

The Centers for Medicare & Medicaid Services Awarded Consumer Operated and Oriented Plan Program Loans in Accordance With Federal Requirements, and Continued Oversight Is Needed (A-05-12-00043)

The Southern African Catholic Bishops' Conference AIDS Office Generally Managed President's Emergency Plan for AIDS Relief Funds and Met Program Goals in Accordance With Award Requirements Audit (A-05-12-00023)

Medicare Compliance Review of Community Medical Center for Calendar Years 2010 and 2011 (A-07-12-01119)

July

07-30-2013

Hospitals' Use of Observation Stays and Short Inpatient Stays for Medicare Beneficiaries (OEI-02-12-00040)

07-24-2013

Lymphedema and Wound Care Institute Added to Corporate Integrity Agreement List

07-23-2013

Advisory Opinion 13-09
(concerning a proposal to offer members of a group purchasing organization ("GPO") an equity interest in the GPO's parent organization in exchange for the member: (1) extending its contract with the GPO for five to seven years; (2) committing not to decrease purchasing volume; and (3) relinquishing its right to a portion of the administrative fees that would otherwise have been passed through to the members.)

07-22-2013

Performance Data for the Senior Medicare Patrol Projects: July 2013 Performance Report (OEI-02-13-00170)

07-19-2013

CGS Administrators, LLC, Paid Unallowable Lower Limb Prosthetics Claims (A-06-12-00055)

Medicare Compliance Review of University of Kansas Hospital for Calendar Years 2009 and 2010 (A-07-11-01105)

Medicare Compliance Review of Via Christi Hospital for Calendar Years 2009 and 2010 (A-07-11-01099)

Wing Memorial Hospital Did Not Always Bill Correctly for Evaluation and Management Services Related to Diagnostic or Therapeutic Procedures and Supartz Injections (A-01-12-00519)

Meritus Medical Center Refunded Overpayments for Physician Claims With Place-of-Service Coding Errors For 2009 Through 2012 (A-01-12-00531)

07-17-2013

Early Implementation of the Consumer Operated and Oriented Plan Loan Program (OEI 01-12-00290)

07-16-2013

Baxano Surgical, Inc. f/k/a TranS1, Inc. Added to Corporate Integrity Agreement List

May Recovery Act Oversight Monthly Report Posted

07-15-2013

Medicare Part B and Beneficiaries Paid for Xolair That Jurisdiction 14 Physicians Discarded Without Documentation (A-01-12-00518)

Sound Inpatient Physicians, Inc. and affiliates Added to Corporate Integrity Agreement List

07-12-2013

Updated Civil Monetary Penalties:

07-11-2013

Podcast: State Regulations for License-Exempt Child Care Providers

License-Exempt Child Care Providers in the Child Care and Development Fund Program (OEI-07-10-00231)

Rockford Human Services Did Not Always Charge Allowable Costs to the Community Services Block Grant - Recovery Act Program (A-05-12-00012)

The New York State Manufacturer Rebate Program Significantly Reduced Medicaid Costs for Home Blood-Glucose Test Strips But Could Achieve Additional Reductions (A-02-11-01042)

Massachusetts Medicaid Payments to Healthbridge Management Did Not Always Comply With Federal and State Requirements (A-01-13-00001)

07-10-2013

LEIE Database Updated with June 2013 Exclusions and Reinstatements

New Instructional Videos:

Updated Corporate Integrity Agreement List: Two New CIAs Added

Kentucky Substantially Met Money Follows the Person Program Requirements (A-04-12-06152)

Noninstitutional Providers in California Did Not Always Reconcile Invoice Records With Credit Balances and Refund to the State Agency the Associated Medicaid Overpayments (A-09-12-02047)

Missouri Claimed Unallowable Medicaid Payments for Individuals With Intellectual and Developmental Disabilities in Intermediate Care Facilities (A-07-12-03180)

07-09-2013

Advisory Opinion 13-08
(concerning a fire protection district's policy of billing only individuals who reside outside the fire protection district for emergency medical services.)

07-08-2013

New Provider Self-Disclosure Online Submission

07-03-2013

State Medicaid Fraud Control Units:
Elements of and Process for Submitting a Complete Data Mining Application

07-02-2013

Podcast: PEPFAR Funds Spending Oversight

Updated Corporate Integrity Agreement List: CIAs Closed

Medicare's Currently Not Collectible Overpayments (OEI-03-11-00670)

Some States Improperly Restrict Eligibility for Medicaid Mandatory Home Health Services (OEI-07-13-00060)

California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Drugs and Supplies Provided in San Diego County (A-09-12-02077)

Medicare Compliance Review of Hospital Español Auxilio Mutuo De Puerto Rico, Inc., For Calendar Years 2010 and 2011 (A-02-12-01026)

Not All Community Services Block Grant Recovery Act Costs Claimed on Behalf of the Community Action Partnership of Natrona County for the Period July 1, 2009, Through September 30, 2010, Were Allowable. (A-07-12-02779)

07-01-2013

Podcast: OIG Monthly Update

Data and Safety Monitoring Boards in NIH Clinical Trials: Meeting Guidance, But Facing Some Issues (OEI-12-11-00070)

Advisory Opinion 13-07
(concerning a tiered rebate program in which the rebate tiers would be reached based on the combination of purchases of both Federally reimbursable products and non-Federally reimbursable products.)

Modification to Advisory Opinion 16-13
(modifying Advisory Opinion 16-13, issued September 18, 2006 that concerned a nonprofit, tax-exempt, charitable organization's proposal to provide financially needy persons who have [diseases redacted] with grants to defray the costs of premiums and cost-sharing obligations under Medicare Part B, Medicare Part D, Medicare Supplementary Health Insurance, and Medicare Advantage.)

June

06-28-2013

Missouri Improperly Claimed Federal Reimbursement for Most Reviewed Medicaid Inpatient Psychiatric Hospital Service and Disproportionate Share Hospital Payments to Hawthorn Children's Psychiatric Hospital (A-05-12-00050)

Indiana Improperly Claimed Federal Reimbursement for All Reviewed Medicaid Inpatient Psychiatric Hospital Service Payments to Evansville State Hospital (A-05-12-00041)

06-27-2013

Advisory Opinion 13-06
(concerning the proposed use of a preferred hospital network as part of Medicare Supplemental Health Insurance ("Medigap") policies.)

The Vietnam Administration for HIV/AIDS Control Did Not Always Manage the President's Emergency Plan for AIDS Relief Funds or Meet Program Goals in Accordance With Award Requirements (A-06-11-00057)

Center for Community and Family Services, Inc., Did Not Expend Head Start and Recovery Act Funds in Accordance With Federal Requirements (A-09-11-01006)

Baptist Medical Center South Complied With Most Medicare Requirements for Billing Inpatient and Outpatient Services for Calendar Years 2009 and 2010 (A-04-12-00083)

Medicare Compliance Followup Review of Tufts Medical Center (A-01-12-00527)

National Government Services Claimed Allowable Administrative Costs for Fiscal Years 2008 and 2009 under Medicare Contract 00450 (A-05-11-00110)

06-26-2013

CGS Administrators, LLC Made Payments for Therapeutic Shoes Furnished to Medicare Beneficiaries in Puerto Rico That Generally Did Not Comply With Federal Requirements (A-02-11-01001)

Missouri Did Not Always Correctly Claim Costs for Medicaid Family Planning Sterilization Procedures for Calendar Years 2009 and 2010 (A-07-12-01117)

06-25-2013

Replacement Schedules for Medicare Continuous Positive Airway Pressure Supplies (OEI-07-12-00250)

Potentially Improper Frequency of Pneumococcal Vaccinations for Medicare Beneficiaries (OEI-07-13-00310)

06-24-2013

Testimony of Gary Cantrell, Deputy Inspector General for Investigations and Stuart Wright, Deputy Inspector General for Evaluation and Inspections, Office of Inspector General before the Senate Committee on Homeland Security and Governmental Affairs on Curbing Prescription Drug Abuse in Medicare

Spotlight On Drug Diversion

Podcast: Drug Diversion Overview

Medicare Inappropriately Paid for Drugs Ordered by Individuals Without Prescribing Authority (OEI-02-09-00608)

06-21-2013

Advisory Opinion 13-05
(concerning an exclusive contract for emergency medical services and transports between a municipality and an ambulance company. The opinion addresses the aspect of the contract that requires the ambulance company to reimburse the municipality for a portion of the costs of providing emergency dispatch services.)

06-20-2013

Prescribers With Questionable Patterns in Medicare Part D (OEI-02-09-00603)

Medicare Compliance Followup Review of Boston Medical Center (A-01-12-00524)

06-19-2013

Medicare Compliance Review of Community Regional Medical Center (A-09-12-02071)

Spectrum Rehabilitation, LLC, Claimed Unallowable Medicare Part B Reimbursement for Outpatient Therapy Services (A-02-11-01044)

Wisconsin Claimed Medicaid Reimbursement for High-Dollar Inpatient Services That Were Unallowable (A-05-11-00037)

Anthem Health Plans of New Hampshire, Inc., Understated Its Medicare Segment Pension Assets as of January 1, 2006 (A-07-13-00406)

Anthem Health Plans of New Hampshire, Inc., Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2003 Through 2005 (A-07-13-00407)

The University of Colorado Denver Did Not Always Claim Selected Costs Charged Directly to Department of Health and Human Services Awards in Accordance With Federal Regulations (A-07-11-06013)

Medicare Compliance Review of the Brooklyn Hospital Center for Calendar Years 2010 and 2011 (A-02-12-01021)

06-18-2013

Multi-agency Taskforce Arrests 42 Orange Co., NY Fugitives in 6 Months

06-17-2013

The Regional Extension Center Program in Texas Met the Scope of Services in Their Cooperative Agreements With the Office of the National Coordinator for Health Information Technology (A-06-12-00023)

Quality Software Services, Inc., Had Not Implemented Universal Serial Bus Device and Port Controls. (A-04-12-05045)

Anthem Health Plans of Maine, Inc., Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2003 Through 2005 (A-07-13-00405)

Anthem Health Plans of Maine, Inc., Overstated Its Medicare Segment Pension Assets as of January 1, 2006 (A-07-13-00404)

Blue Cross Blue Shield of Georgia Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2006 Through 2009 (A-07-12-00398)

Blue Cross Blue Shield of Georgia Overstated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Excess Liabilities as of May 31, 2009 (A-07-12-00397)

Medicare Compliance Review of Aibonito Mennonite General Hospital, Inc., for Calendar Years 2010 and 2011 (A-02-12-01032)

06-14-2013

Ji Hae Kim Added to Most Wanted Fugitives List

Advisory Opinion 13-04
(concerning an arrangement among a county, a county health district, and various municipalities concerning the provision of non-emergency ambulance transportation services by the county health district.)

Modification to Advisory Opinion 11-05
(modifying Advisory Opinion 11-05, issued 05-13-2011, that concerned a tax-exempt charitable organization's: (1) proposal to provide financial assistance with cost-sharing obligations for certain genetic tests to financially needy individuals, including but not limited to Medicare and Medicaid beneficiaries, and (2) current practice of providing vouchers for free genetic tests to individuals who are uninsured or whose insurance does not cover genetic tests.)

06-13-2013

Illinois State Medicaid Fraud Control Unit: 2012 Onsite Review (OEI-07-12-00510)

Advisory Opinion 13-03
(concerning a clinical laboratory company’s proposal to establish a subsidiary that would contract with physician practices to enable the practices to provide laboratory services to the physicians’ patients who are not Federal health care program beneficiaries.)

Indiana Improperly Claimed Federal Reimbursement for Most Medicaid Inpatient Psychiatric Hospital Service and Disproportionate Share Hospital Payments to Evansville Psychiatric Children's Center (A-05-12-00040)

Palmetto GBA, LLC, Inappropriately Paid Hospitals' Medicare Claims Subject to the Postacute Care Transfer Policy in
Jurisdiction 1 (A-09-12-02038)

Medicare Payments to Connecticut Physicians for Full Vials of Herceptin Were Generally Correct (A-01-12-00515)

Medicare Payments to Jurisdiction 14 Physicians for Full Vials of Herceptin Were Generally Correct (A-01-12-00514)

06-12-2013

Thomas Jefferson University Generally Claimed Selected Costs Charged Directly to Department of Health and Human Services Awards in Accordance With Federal Regulations (A-03-11-03300)

Updated Civil Monetary Penalties:

06-11-2013

OIG Updates LEIE Search Function, Downloadable Databases

Comparing Lab Test Payment Rates: Medicare Could Achieve Substantial Savings (OEI-07-11-00010)

Advisory Opinion 13-02
(concerning a proposal to establish a limited liability company that would enter into arrangements with manufacturers and other entities to provide industrial orthotics for use by these entities' employees.)

06-10-2013