What's New

See also: Archive (2024-2017)

January 2026

01-06-2026

• Essence Healthcare, Inc., Did Not Comply With Federal Requirement for Reporting Direct and Indirect Remunerations for Contract Years 2017 Through 2020 A-03-22-00002

December 2025

12-23-2025

• Medicaid Agencies Made Millions in Unallowable Capitation Payments to Managed Care Organizations on Behalf of Deceased Enrollees A-04-23-09010
• The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2024 in Accordance With Federal Requirements OAS-25-04-058

12-22-2025

• Illinois Made Unallowable Managed Care Capitation Payments on Behalf of Incarcerated Medicaid Enrollees A-05-24-00019
• Nine of Thirty Selected Assisted Living Facilities Did Not Comply With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments A-02-23-01012

12-18-2025

• Some Selected Health Centers Received Duplicate Reimbursement From HRSA For COVID-19 Testing Services A-02-23-02009
• Advisory Opinion 25-11 Favorable opinion regarding certain discount structures that that a pharmaceutical manufacturer offers on particular vaccines.

12-17-2025

• Trends in Dual-Eligible Enrollees' Access to Drugs Under Part D, 2011-2025 OEI-05-25-00350
• Medicare Home Health Agency Provider Compliance Audit: Guardian Home Care, LLC A-07-24-05146
• Updated Corporate Integrity Agreements: CIAs closed in November 2025

12-16-2025

• Excluding Noncovered Versions Would Have Substantially Lowered Fourth-Quarter 2025 Part B Payment Amounts for Stelara Biosimilars OEI-BL-25-00240
• Medicare Advantage Compliance Audit of Specific Diagnosis Codes Humana Health Benefit of Louisiana (Contract H1951) Submitted to CMS A-06-21-02001
• Oklahoma Medicaid Fraud Control Unit: 2025 Inspection OEI-07-25-00060

12-15-2025

• New Jersey Should Improve Its Oversight of Nursing Homes’ Compliance With Background Check Requirements A-02-23-01011

12-12-2025

• The Indian Health Service Did Not Ensure That Commissioned Corps Officers' Background Investigations Complied With Federal Requirements A-01-24-01500
• Arkansas Could Better Ensure That Intermediate Care Facilities for Individuals With Intellectual Disabilities Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control OAS-25-06-029
• Updated: Corporate Integrity Agreements

12-11-2025

• The National Institutes of Health Generally Implemented the Safe Workplace Federal Reporting Requirement, but Opportunities Exist To Improve the Reporting and Monitoring Processes A-05-24-00002

12-10-2025

• LEIE Database Updated with November 2025 Exclusions and Reinstatements
• Job Posting: Associate and Senior Counsel Job Posting

12-09-2025

• Updated: Fraud Self-Disclosures
• Updated: CMP and Affirmative Exclusions
• Updated: COVID-19

12-08-2025

• Updated Heightened Scrutiny: Aesculap Implant Systems LLC
• Podiatrists’ Claims for Routine Foot Care Services Did Not Comply With Medicare Requirements A-09-22-03011
• 2026 Summer OIG Health Care Fraud and Abuse Legal Internship Announcement

12-05-2025

• New Jersey Did Not Ensure Providers Complied With Federal and State Requirements at All 20 Adult Day Health Services Facilities Audited A-02-24-01009
• Podiatrists’ Claims for Evaluation and Management Services Did Not Comply With Medicare Requirements A-09-22-03012
• Updated: Corporate Integrity Agreements

12-04-2025

Medicare Improperly Paid Selected Optometrists for Services Provided to Enrollees at Nursing Facilities A-05-24-00009

Florida Retina Institute Generally Met Medicare Requirements for Ophthalmology Services Provided on the Same Day as Eye Injections A-04-22-04086

12-01-2025

Four of Thirty Selected Dental Providers Did Not Comply With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments A-02-23-01013

November 2025

11-26-2025

• Gaps in NIH’s Oversight Put Millions in Funding for Other Transactions at Greater Risk of Fraud, Waste, or Abuse OEI-04-24-00140

11-25-2025

• Medicare Payments for Continuous Glucose Monitors and Supplies Exceeded Supplier Costs and Retail Market Prices, Indicating Medicare Can Save At Least Tens of Millions of Dollars in One Year OEI-04-23-00430
• Video: Combating Durable Medical Equipment Fraud

11-24-2025

• Updated: EMTALA/Patient Dumping
• Updated: CMP and Affirmative Exclusions

11-21-2025

• Updated Heightened Scrutiny: CVS Pharmacy, Inc.

11-20-2025

• Updated: Annual Inflation Updates to the Annual Cap on Patient Engagement Tools and Supports Under 42 CFR § 1001.952(hh)

11-19-2025

• CMS Put $11.2 Billion at Risk of Fraud, Waste, and Abuse by Not Properly Closing Contracts A-04-24-02048
• Dermatology Providers Generally Met Medicare Requirements for Evaluation and Management Services Performed on Same Day as Minor Surgical Procedures A-04-21-04083

11-18-2025

• Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2025 OEI-03-26-00030
• Nearly All Skilled Nursing Services Provided by Pinnacle Multicare Nursing and Rehabilitation Center Did Not Meet Medicare Payment Requirements A-02-22-01017

11-17-2025

• Updated: Work Plan

11-14-2025

• West Virginia Did Not Comply With Intake, Screening, Assessment, and Investigation Requirements for Responding to Reports of Child Abuse and Neglect OAS-25-01-011
• California Met Some Requirements of the Projects for Assistance in Transition From Homelessness Program but Did Not Accurately Report Program Activities for Selected Providers A-09-23-01002
• The National Institutes of Health Needs to Improve the Cybersecurity of the All of Us Research Program to Protect Participant Data A-18-24-06111

11-12-2025

• Updated: Fraud Self-Disclosures
• Updated: CMP and Affirmative Exclusions

11-10-2025

• LEIE Database Updated with October 2025 Exclusions and Reinstatements
• Office of Inspector General's Partnership With the Office of the Kentucky State Auditor of Public Accounts: State Auditor's Report How Kentucky Failed to Prevent Over $800 Million of Medicaid Waste A-09-23-02005

11-07-2025

• Texas' Ambulance Services Supplemental Payment Program Did Not Comply With Federal and State Reimbursement Requirements A-06-23-01003
• Pennsylvania Correctly Invoiced Rebates to Manufacturers for Most Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-03-24-00206

11-05-2025

• 2025 Top Unimplemented Recommendations

October 2025

10-30-2025

• South Carolina Did Not Comply With Federal Waiver and State Requirements at 19 of 20 Adult Day Care Facilities A-04-24-00137
• Medicare Home Health Agency Provider Compliance Audit: VNA Care Network A-05-22-00016

10-29-2025

• CMS's Special Focus Facility Program for Nursing Homes Has Not Yielded Lasting Improvements OEI-01-25-00050
• Special Focus Facility Program Nursing Homes, 2013–2022 OEI-01-23-00052

10-28-2025

• Medicare Improperly Paid Suppliers $22.7 Million Over 7 Years for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Enrollees During Inpatient Stays OAS-24-09-005

10-24-2025

• Connecticut Could Better Ensure That Intermediate Care Facilities for Individuals With Intellectual Disabilities Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control OAS-25-01-040
• Updated: Fraud Self-Disclosures

10-23-2025

• Updated: CMP and Affirmative Exclusions

10-15-2025

• Summary Report of Prior Office of Inspector General Penetration Tests of 10 State MMIS and E&E Systems A-18-24-00002
• Indiana Did Not Fully Comply With Federal Waiver and State Health, Safety, and Administrative Requirements at 30 Residential Settings A-05-24-00013
• Updated: Work Plan

10-10-2025

• Updated: Heightened Scrutiny
• LEIE Database Updated with September 2025 Exclusions and Reinstatements

10-07-2025

• Many Medicare Advantage and Medicaid Managed Care Plans Have Limited Behavioral Health Provider Networks and Inactive Providers OEI-02-23-00540
• Medicare Could Have Saved $301.5 Million if Bundled Payment Rates for Opioid-Use-Disorder Treatment Services Had Reflected Services Provided to Enrollees A-09-23-03002
• Vermont Medicaid Fraud Control Unit: 2024 Inspection OEI-07-24-00340Updated: Corporate Integrity Agreements

10-06-2025

• Updated: Fraud Risk and Heightened Scrutiny 2025 Q1-Q4

September 2025

09-30-2025

• Updated: CMP and Affirmative Exclusions

09-29-2025

• HRSA Rural Communities Opioid Response Program Award Recipients Generally Met All Core Activities and Benchmarks A-06-23-07000

09-26-2025

• Hospitals Charged CMS for Trauma Team Activations That Did Not Comply With Federal Requirements A-01-23-00500

09-24-2025

• Deficiencies With Incorporating Required Cybersecurity Language in HHS Contracts and Timeliness of Contractor Incident Reporting A-18-22-06100

09-23-2025

• Seventeen of Twenty-Five Selected Hospitals Did Not Comply or May Not Have Complied With the Provider Relief Fund Balance Billing Requirement A-02-22-01018

09-22-2025

• Texas Did Not Calculate or Collect Hospice Cap Overpayments Totaling $10.5 Million A-06-24-09001

09-19-2025

• New Jersey Did Not Ensure That Some Medicaid Personal Care Assistant Services Provided Under the Personal Preference Program Met Federal and State Requirements A-02-22-01024

09-18-2025

• Nursing Homes Failed To Report 43 Percent of Falls With Major Injury and Hospitalization Among Their Medicare-Enrolled Residents OEI-05-24-00180
• Serious Falls Resulting in Hospitalization Among Medicare-Enrolled Nursing Home Residents, July 2022–June 2023 OEI-05-24-00181

09-17-2025

Updated:

• EMTALA/Patient Dumping
• CMP and Affirmative Exclusions
• Fraud Self-Disclosures
• Stipulated Penalties and Material Breaches

09-16-2025

The Patient Safety Organization Program: Key Barriers Impeding Nationwide Progress Toward Reducing Patient Harm in Hospitals OEI-01-24-00150

09-15-2025

• Updated: Work Plan

09-12-2025

2026 Spring OIG Health Care Fraud and Abuse Legal Internship Announcement

09-11-2025

• Advisory Opinion 25-10 Favorable opinion regarding an arrangement pursuant to which a company operationalized and makes financial contributions to a foundation, and the foundation provides grants to families of children receiving a particular type of therapy.
• Puerto Rico Medicaid Fraud Control Unit: 2024 Onsite Review OEI-06-24-00300

09-10-2025

• LEIE Database Updated with August 2025 Exclusions and Reinstatements
• Mississippi Did Not Report and Return All Medicaid Overpayments for the State's Medicaid Fraud Control Unit Cases A-06-24-04002
• Updated: Corporate Integrity Agreements

09-09-2025

• Most Children Enrolled in Medicaid Did Not Receive Timely Suicide-Related Followup Care OEI-07-23-00510
• Hawaii Did Not Ensure That Selected Nursing Facilities Complied With Federal and State Background Check Requirements A-09-23-02003

09-08-2025

• Medicare Part B Payment Trends for Skin Substitutes Raise Major Concerns About Fraud, Waste, and Abuse OEI-BL-24-00420
• By Requiring Emergency Preparedness Plans for Independent Labs, CMS Could Better Ensure That Medicare Enrollees Have Access to Infectious-Disease Diagnostic Testing During a Public Health Emergency A-09-23-03003

09-05-2025

• ACF Did Not Award, Monitor, and Close Selected Contracts for the Unaccompanied Alien Children Program in Accordance With Federal Requirements A-06-22-07000

09-04-2025

• Enforcement Alert: Information Blocking

09-03-2025

• Some Medicaid Managed Care Plans Made Few or No Referrals of Potential Provider Fraud OEI-03-22-00410
• National Government Services, Inc., Reopened and Corrected Cost Report Final Settlements for Desk Reviews Only With Obvious Errors To Correct Payments Made to Medicare Providers A-06-24-05004

09-02-2025

• Novitas Solutions, Inc., Reopened and Corrected Cost Report Final Settlements for Desk Reviews Only With Obvious Errors To Correct Payments Made to Medicare Providers A-06-24-05003

August 2025

08-29-2025

• ACF Did Not Monitor States' Compliance With All American Rescue Plan Child Care Stabilization Grant Provisions A-02-23-02007

08-28-2025

• Billing for Remote Patient Monitoring in Medicare OEI-02-23-00261Most Health Centers Provide Some Behavioral Health Services to Patients With Substance Use Disorder, Despite Facing Challenges That Limit Comprehensive Treatment OEI-BL-22-00520

08-27-2025

• CMS Should Confirm It Is Receiving Medicare Postoperative Visit Data on Global Surgeries When Reporting Is Required A-05-20-00027

08-21-2025

• Medicare Enrollees Left Acute-Care Hospitals Against Medical Advice at Increasing Rates A-04-24-03003
• Companion Data Services, LLC, Did Not Claim Some Allowable Medicare Excess Plan Costs Through Its Incurred Cost Proposals OAS-25-07-047
• Companion Data Services, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-24-00641
• Companion Data Services, LLC, Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan III Costs Through Its Incurred Cost Proposals A-07-24-00644

08-20-2025

• Companion Data Services, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals OAS-25-07-022
• Companion Data Services, LLC, Understated Its Medicare Segment Pension Assets as of January 1, 2022 OAS-25-07-023
• Companion Data Services, LLC, Overstated Its Excess Plan Medicare Segment Pension Assets as of January 1, 2022 OAS-25-07-027

08-19-2025

• Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan III Costs Through Its Incurred Cost Proposals OAS-25-07-048
• Palmetto Government Benefits Administrator, LLC, Did Not Claim Some Allowable Medicare Excess Plan Costs Through Its Incurred Cost Proposals OAS-25-07-046
• Palmetto Government Benefits Administrator, LLC, Understated Its Excess Plan Medicare Segment Pension Assets as of January 1, 2022 OAS-25-07-028

08-18-2025

• Palmetto Government Benefits Administrator, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2022 A-07-23-00638
• Palmetto Government Benefits Administrator, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals OAS-25-07-020
• Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposal A-07-24-00640

08-15-2025

• Updated: Work Plan
• Blue Cross Blue Shield of South Carolina Overstated Its Excess Plan Partial Medicare Segment Pension Assets as of January 1, 2022 OAS-25-07-026
• Blue Cross Blue Shield of South Carolina Overstated Its Supplemental Executive Retirement Plan III Medicare Allowable Segment Pension Assets as of January 1, 2022 A-07-24-00647

08-14-2025

• Alabama Did Not Always Verify Selected Nursing Homes' Compliance With Background Check Requirements A-04-24-08104
• CGS Administrators, LLC, Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan III Costs Through Its Incurred Cost Proposals OAS-25-07-049Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2025 OEI-03-25-00040

08-13-2025

• CGS Administrators, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals OAS-25-07-051
• CGS Administrators, LLC, Did Not Claim Some Allowable Medicare Excess Plan Costs Through Its Incurred Cost Proposals OAS-25-07-052

08-12-2025

• Advisory Opinion 25-09 Favorable opinion regarding remuneration to physicians with an ownership interest in a device manufacturer.

08-11-2025

• Most Wanted Fugitive: Herbert "Herb" Kimble

08-08-2025

• LEIE Database Updated with July 2025 Exclusions and Reinstatements
• Updated: EMTALA/Patient Dumping
• Updated: CMP and Affirmative Exclusions
• Updated: Fraud Self-Disclosures

08-07-2025

• During Hurricanes Fiona and Ian, HHS Helped Minimize Disruptions to Medical Services at Select Health Care Facilities OEI-04-23-00420
• Updated: Corporate Integrity Agreements

08-05-2025

• Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2023 Average Sales Prices OEI-03-25-00050
• Florida Did Not Fully Comply With Federal Reporting and Oversight Requirements for Its Opioid Response Grant A-04-24-08106

08-04-2025

• Analysis of Selected Nursing Facilities' Use of Medicaid Reimbursement for Direct Care Compensation A-07-23-04134

08-01-2025

• Updated: Corporate Integrity Agreements

July 2025

07-21-2025

• Updated: Corporate Integrity Agreements

07-18-2025

• Findings of Whistleblower Retaliation by IHS Tribal 638 Health Care Facility Management Official
• Wisconsin Physicians Service Government Health Administrators Reopened and Corrected Cost Report Final Settlements for Desk Reviews Only With Obvious Errors To Correct Payments Made to Medicare Providers A-06-24-04001
• Kentucky Did Not Meet All of the Requirements for the COVID-19 Screening Testing Program at K-12 Schools A-05-23-00018
• ASPR Established Adequate Controls for Maintaining Physical Security and Inventory Records at Stockpile Site E OAS-25-04-062
• Updated: CMP and Affirmative Exclusions
• Updated: Fraud Self-Disclosures

07-17-2025

• Oklahoma 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-06-24-09002

07-15-2025

• Updated: Work Plan

07-14-2025

• Wisconsin Made at Least $18.5 Million in Improper Fee-For-Service Medicaid Payments for Applied Behavior Analysis Provided to Children Diagnoses With Autism A-06-23-01002

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 ActionsDepartment 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