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HHS-OIG's Oversight of COVID-19 Response and Recovery

We accelerated efforts to begin reviews that examine the effectiveness of the public health response through an independent and objective lens.

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OIG is publishing audits and evaluations assessing COVID-19 preparedness and response in programs that serve HHS beneficiaries. Our reports result in timely information and may provide recommendations regarding HHS programs and operations. The expected impact of OIG's reports varies from direct cost savings and recovery of misspent funds to improvements in payment efficiency, program operations, quality of services, and public safety. Completed reports related to COVID-19 are in the table below.

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Search Completed Reports

Reports are listed in reverse chronological order.
Please use the filter tool to search completed reports.

Title Objectives Key Findings

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)

June 28, 2021

Assess whether the Centers for Medicare and Medicaid Services (CMS) designed and implemented effective internal controls related to hospital preparedness for emerging infectious diseases such as COVID-19.

  • CMS's controls were well-designed and implemented to achieve its control objective and respond to risks, but CMS's authority is not sufficient for it to ensure preparedness for emerging infectious diseases including COVID-19 at 4,200 accredited hospitals.

COVID-19 Had a Devastating Impact on Medicare Beneficiaries in Nursing Homes During 2020 (OEI-02-20-00490)

June 22, 2021

Determine how many Medicare beneficiaries in nursing homes were affected by COVID-19 in 2020.

Understand beneficiaries' characteristics that are associated with greater risk of contracting the virus.

  • 2 in 5 Medicare beneficiaries in nursing homes were diagnosed with either COVID-19 or likely COVID-19 in 2020.
  • Almost 1,000 more beneficiaries died per day in April 2020 than in April 2019.
  • Overall mortality in nursing homes increased to 22 percent in 2020 from 17 percent in 2019.
  • About half of Black, Hispanic, and Asian beneficiaries in nursing homes had or likely had COVID-19, and 41 percent of White beneficiaries did.
  • Understanding the pandemic's effects on nursing home residents is necessary if tragedies like this are to be averted.

Hospitals Reported That the COVID-19 Pandemic Has Significantly Strained Health Care Delivery: Results of a National Pulse Survey February 22-26, 2021 (OEI-09-21-00140)

March 24, 2021

Provide a national snapshot, from the perspective of hospital administrators, on how responding to the COVID-19 pandemic has affected hospitals' capacity to care for patients, staff, and communities nearly a year after COVID-19 was declared a pandemic.

  • Hospital administrators described difficulty balancing the complex and resource-intensive care needed for COVID-19 patients with efforts to resume routine hospital care. Specifically, they described significant challenges related to health care delivery, staffing, vaccinations, and finances.
  • Hospitals reported a range of strategies they have used to address their challenges and identified areas in which further government support could help as they continue responding to the pandemic.

Opioid Use in Medicare Part D During the Onset of the COVID-19 Pandemic (OEI-02-20-00400)

February 4, 2021

Describe opioid use in Part D during the onset of COVID-19, focusing on the first 8 months of 2020.

  • At least 5,000 Part D beneficiaries per month suffered an opioid overdose.
  • Further, almost a quarter of a million beneficiaries received high amounts of opioids.
  • During this time, the number of beneficiaries receiving drugs for medication-assisted treatment increased slightly.
  • The number of beneficiaries receiving naloxone—a drug that can reverse an opioid overdose—declined through April but increased in the following months.

Federal COVID-19 Testing Report: Data Insights from Six Federal Health Programs

January 14, 2021

Provide information on COVID-19 testing paid for by Medicare Part B from February 1, 2020, to August 31, 2020.

  • 5,090,175 beneficiaries received at least one COVID-19 test paid for by Part B, which was 13% of total Part B beneficiaries.
  • Part B paid more than $551 million for 7.98 million COVID-19 tests administered.
  • Testing of beneficiaries was generally proportional to the demographic characteristics of the Part B population.

Onsite Surveys of Nursing Homes During the COVID-19 Pandemic: March 23-May 30 (OEI-01-20-00430)

December 22, 2020

Determine the number and results of surveys of nursing homes conducted by the Centers for Medicare & Medicaid Services (CMS) and State survey agencies (States) from March 23 through May 30, 2020.

Describe challenges that CMS and States experienced in conducting nursing home oversight during the COVID-19 pandemic and their insights into their experiences.

  • States conducted onsite surveys at 31 percent of nursing homes from March 23 through May 30, 2020, fewer than during the same time period in 2019 when States and CMS were under normal operations.
  • These surveys resulted in few deficiencies but allowed States to provide nursing homes with guidance and other support.
  • States had challenges in securing personal protective equipment and staff to conduct onsite surveys.

Opioid Treatment Programs Reported Challenges Encountered During the COVID-19 Pandemic and Actions Taken To Address Them (A-09-20-01001)

November 23, 2020

Identify challenges that opioid treatment programs (OTPs) have encountered during the COVID-19 pandemic.

Identify actions that OTPs have taken to address those challenges while ensuring the continuity of needed services and protecting the health and safety of their patients and staff.

  • OTPs reported challenges related to maintaining pre-pandemic service levels, managing impacts on facility, and implementing and using telehealth, and others.
  • OTPs reported actions taken that included encouraging or requiring various personal safety measures for patients and staff, implementing or expanding the use of telehealth to continue providing services, and increasing the number of take-home doses to reduce the number of patients visiting facilities.

Office of Refugee Resettlement Ensured That Selected Care Providers Were Prepared To Respond to the COVID-19 Pandemic (A-04-20-02031)

November 9, 2020

Determine whether Office of Refugee Resettlement (ORR) ensured that selected facilities followed ORR requirements in preparing for and responding to communicable diseases, such as COVID-19.

  • The 11 selected facilities that we reviewed were generally prepared to respond to an emergency event, such as the COVID-19 pandemic, in accordance with Federal guidance. Specifically, they had policies and procedures, the capability to quarantine COVID-19 cases in their facilities, and adequate personal protective equipment.

National Snapshot of State Agency Approaches to Child Care During the COVID-19 (A-07-20-06092)

October 1, 2020

Identify the approaches that State agencies adopted to ensure access to safe child care as well as to protect the providers rendering that care in their Child Care and Development Fund (CCDF) programs in response to the COVID-19 pandemic.

  • All State agencies reported that they issued guidance to child care providers on protective measures recommended by the Centers for Disease Control and Prevention, and almost all State agencies stated that they were following the provisions of their disaster plans.
  • Many State agencies used the flexibilities afforded to them by the Administration for Children and Families (ACF), the cognizant Federal agency, to lessen the impact of COVID-19 on child care providers and to ensure continued access to child care.
  • To implement changes to their CCDF programs, many State agencies sought changes in their State requirements, requested waivers from ACF, and submitted CCDF plan amendments.

Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020 (OEI-06-20-00300)

April 6, 2020

Identify hospitals' challenges and needs in responding to the COVID-19 pandemic in a national snapshot.

  • Hospitals reported that their most significant challenges centered on testing and caring for patients with known or suspected COVID-19 and keeping staff safe.
  • Hospitals also reported substantial challenges maintaining or expanding their facilities' capacity to treat patients with COVID-19.
  • Hospitals described specific challenges, mitigation strategies, and needs for assistance related to personal protective equipment, testing, staffing, supplies and durable equipment; maintaining or expanding facility capacity; and financial concerns.