What's New
December 2020
12-31-2020
- Advisory Opinion 20-09 (regarding a program where a pharmaceutical manufacturer provides financial assistance for travel, lodging, and other expenses to certain patients prescribed the manufacturer's
- The Centers for Medicare & Medicaid Services Could Improve Its Wage Index Adjustment for Hospitals in Areas With the Lowest Wages
12-30-2020
12-29-2020
12-28-2020
- States Could Do More to Oversee Spending and Contain Medicaid Costs for Specialty Drugs OEI-03-17-00430
- Advisory Opinion 20-07 (regarding a web-based platform where health care facilities and clinicians would, in particular circumstances, remit to patients and the patients' payors a portion of the claim
- Medicare Home Health Agency Provider Compliance Audit: Tender Touch Health Care Services A-04-18-07077
12-23-2020
- Advisory Opinion 20-06 (regarding a management company's provision of below fair market value Medicaid enrollment application assistance services to certain individuals and affiliated skilled nursing
- Aspects of Texas' Quality Incentive Payment Program Raise Questions About Its Ability To Promote Economy and Efficiency in the Medicaid Program A-06-18-07001
12-22-2020
- Onsite Surveys of Nursing Homes During the COVID-19 Pandemic: March 23-May 30, 2020 OEI-01-20-00430
- Despite Savings on Many Lab Tests in 2019, Total Medicare Spending Increased Slightly Because of Increased Utilization for Certain High-Priced Tests OEI-09-20-00450
12-21-2020
- Updated: Corporate Integrity Agreements
- The Office of Refugee Resettlement Did Not Award and Manage the Homestead Influx Care Facility Contracts in Accordance With Federal Requirements A-12-20-20001
- Indian Health Service Facilities Made Progress Incorporating Patient Protection Policies, but Challenges Remain OEI-06-19-00331
- Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Tullahoma, Tennessee A-02-16-01024
12-18-2020
12-16-2020
- HHS Operating Division Needs to Improve Controls Over Key Application to Protect Sensitive Data A-18-19-06002
- Opioids in Medicaid: Concerns About Opioid Use Among Beneficiaries in Six Appalachian States OEI-05-19-00410
- Medicare Home Health Agency Provider Compliance Audit: Total Patient Care Home Health, LLC A-06-16-05005
12-15-2020
12-14-2020
- Updated COVID-19 FAQs
- Incidence of Adverse Events in Indian Health Service Hospitals OEI-06-17-00530
- Instances of IHS Labor and Delivery Care Not Following National Clinical Guidelines or Best Practices OEI-06-19-00190
- Although CDC Implemented Corrective Actions To Improve Oversight of the President's Emergency Plan for AIDS Relief Recipients, Some Internal Control Weaknesses Remained A-04-18-01010
- Risk Assessment Puerto Rico Medicaid Program A-02-20-01011
12-11-2020
12-10-2020
- Updated COVID-19 FAQs
- LEIE Database Updated with November 2020 Exclusions and Reinstatements
- Few Patients Received High Amounts of Opioids from IHS-Run Pharmacies OEI-05-18-00470
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2019 in Accordance With Federal Requirements A-04-20-04077
12-09-2020
- Updated Stipulated Penalties and Exclusion for Material Breach
- Updated Provider Self-Disclosure Settlements
- Updated Civil Monetary Penalties and Affirmative Exclusions
12-08-2020
12-04-2020
12-03-2020
12-02-2020
- Press Release: HHS-OIG�s Work Could Save Taxpayers Billions of Dollars, New Report Says
- 2020 Fall Semiannual Report to Congress
- Nebraska Claimed Almost All Medicaid Payments for Targeted Case Management Services in Accordance With Federal Requirements but Claimed Some Unallowable Duplicate Payments A-07-19-03239
November 2020
11-27-2020
11-24-2020
11-23-2020
- Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Payson, Arizona. A-02-16-01023
- Opioid Treatment Programs Reported Challenges Encountered During the COVID-19 Pandemic and Actions Taken To Address Them A-09-20-01001
- Updated COVID-19 Fraud Alert
11-20-2020
- Medicare Home Health Agency Provider Compliance Audit: The Palace at Home A-04-17-07067
- Final Rule: Medicare and State Health Care Programs: Fraud and Abuse; Revisions to Safe Harbors under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements Fact
- Updated: Corporate Integrity Agreements
11-19-2020
- Ohio Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00023
- Medicare Hospital Provider Compliance Audit: Edward W. Sparrow Hospital A-05-18-00045
11-18-2020
- Hospitals Did Not Comply With Medicare Requirements for Reporting Cardiac Device Credits A-01-18-00502
- Cahaba Government Benefits Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00577
- Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00578
11-17-2020
- 2020 Top Management and Performance Challenges Facing HHS
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2020 OEI-03-21-00050
11-16-2020
- In Selected States, 67 of 100 Health Centers Did Not Use Their HRSA Access Increases in Mental Health and Substance Abuse Services Grant Funding in Accordance With Federal Requirements A-02-19-02001
- Updated: Work Plan
- Special Fraud Alert: Speaker Programs
- Updated: Corporate Integrity Agreements
11-12-2020
- Ohio Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries A-05-18-00027
- Updated: Corporate Integrity Agreements
11-10-2020
- Advocating for the Nation's Elder Population: Operation CARE
- Updated: Corporate Integrity Agreements
- LEIE Database Updated with October 2020 Exclusions and Reinstatements
11-09-2020
11-06-2020
- CMS Did Not Ensure That Medicare Hospital Payments for Claims That Included Medical Device Credits Were Reduced in Accordance With Federal Regulations, Resulting in as Much as $35 Million in Overpayme
- Cahaba Government Benefits Administrators, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00575
- Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00576
11-03-2020
11-02-2020
- Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Central Jersey Home Care and Hospice, Inc. A-02-17-01025
- Updated: Corporate Integrity Agreements
October 2020
10-30-2020
- Medicare Hospital Provider Compliance Audit: St Francis Hospital A-05-18-00048
- Minnesota Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00018
10-27-2020
10-26-2020
- Massachusetts Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-06-18-04001
- Updated: Work Plan
- Updated: Corporate Integrity Agreements
10-23-2020
10-16-2020
10-15-2020
10-13-2020
10-09-2020
- Update on Oversight of Opioid Prescribing and Monitoring of Opioid Use: States Have Taken Action To Address the Opioid Epidemic A-09-20-01000
- Updated: Fraud Risk Indicator
10-08-2020
- Remarks: 2020 Health Care Fraud Takedown
- LEIE Database Updated with September 2020 Exclusions and Reinstatements
10-07-2020
10-06-2020
- HHS Made Some Progress Toward Compliance With the Geospatial Data Act A-18-20-11500
- Colorado Improperly Claimed Millions in Enhanced Federal Medicaid Reimbursement for New Adult Group Beneficiaries Because of a Data Processing Error A-07-17-02807
- Medicare Critical Care Services Provider Compliance Audit: Clinical Practices of the University of Pennsylvania A-03-18-00003
10-05-2020
- Speech: Connecting the Dots: An OIG Update , by Christi A. Grimm, Principal Deputy Inspector General
10-02-2020
- Risk Assessment of Food and Drug Administration's Purchase Card Program A-04-19-06234
- Medicare Hospital Provider Compliance Audit: Alta Bates Summit Medical Center A-04-19-08071
- Updated: Corporate Integrity Agreements
10-01-2020
- National Snapshot of State Agency Approaches to Child Care During the COVID-19 Pandemic A-07-20-06092
- Updated: Work Plan
- Youth For Tomorrow - New Life Center, Inc., an Administration for Children and Families Grantee, Did Not Comply With All Applicable Federal Policies and Requirements A-03-16-00250
September 2020
09-30-2020
09-29-2020
- FDA's Risk Evaluation and Mitigation Strategies: Uncertain Effectiveness in Addressing the Opioid Crisis OEI-01-17-00510
- North Carolina Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-04-16-00112
09-28-2020
- Healthcare Dive Op-Ed by Christi A. Grimm: Medicare Advantage should not 'game the system' but prioritize patient care, honest billing
- Updated: Corporate Integrity Agreements
09-25-2020
09-24-2020
- CMS's Monitoring Activities for Ensuring That Medicare Accountable Care Organizations Report Complete and Accurate Data on Quality Measures Were Generally Effective, but There Were Weaknesses That Cou
- Updated: Corporate Integrity Agreements
- Connecticut Did Not Meet Federal and State Requirements for Claiming Medicaid School-Based Child Health Services for Hartford Public Schools A-01-19-00003
09-23-2020
- Updated: Corporate Integrity Agreements
- Arkansas Medicaid Fraud Control Unit: 2019 Onsite Inspection OEI-12-19-00450
- Oregon's Oversight Did Not Ensure That Four Coordinated-Care Organizations Complied With Selected Medicaid Requirements Related to Access to Care and Quality of Care A-09-18-03035
- Advisory Opinion 20-05 (regarding a pharmaceutical manufacturer's proposal to provide cost-sharing assistance directly to Medicare beneficiaries who are prescribed either of two formulations of its dr
- CMS Should Pursue Strategies To Increase the Number of At Risk Beneficiaries Acquiring Naloxone Through Medicaid OEI-BL-18-00360
09-22-2020
- Vermont Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-19-06086
- North Carolina Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-19-08070
09-21-2020
- Updated: Work Plan
- Incorrect Acute Stroke Diagnosis Codes Submitted by Traditional Medicare Providers Resulted in Millions of Dollars in Increased Payments to Medicare Advantage Organizations A-07-17-01176
- Updated: Corporate Integrity Agreements
- Illinois Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-05-18-00037
09-18-2020
- Medicare-Allowed Charges for Noninvasive Ventilators Are Substantially Higher Than Payment Rates of Select Non-Medicare Payers A-05-20-00008
- Updated: Corporate Integrity Agreements
- Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals A-07-20-00590
09-17-2020
- Southwest Key Programs Failed To Protect Federal Funds Intended for the Care and Placement of Unaccompanied Alien Children A-06-17-07004
- Indiana Did Not Ensure That Medicaid Payments Were Made Properly for Some Claims Identified as Having Third-Party Coverage A-05-18-00046
- Medicare Home Health Agency Provider Compliance Audit: Mercy Health Visiting Nurse Services A-05-18-00035
09-16-2020
- Group Health Incorporated Overstated Its Allowable Medicare Supplemental Executive Retirement Plan Costs for Calendar Years 2009 Through 2016 A-07-19-00582
- Group Health Incorporated Claimed Some Unallowable Medicare Postretirement Benefit Costs for Calendar Years 2009 Through 2016 A-07-19-00583
- Maine Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-18-06079
09-15-2020
- Some Manufacturers Reported Inaccurate Drug Product Data to CMS OEI-03-19-00200
- Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of August 31, 2016 A-07-19-00580
- Group Health Incorporated Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2009 Through 2016 A-07-19-00581
- Updated: Work Plan
- Group Health Incorporated Overstated Its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Pension
09-14-2020
09-11-2020
09-10-2020
- LEIE Database Updated with August 2020 Exclusions and Reinstatements
- Updated: Provider Self-Disclosure Settlements
- Billions in Estimated Medicare Advantage Payments From Diagnoses Reported Only on Health Risk Assessments Raise Concerns OEI-03-17-00471
09-09-2020
- Audit of Medicare Part D Pharmacy Fees: Horizon Blue Cross Blue Shield, Inc. A-03-18-00007
- Updated Civil Monetary Penalties and Affirmative Exclusions
09-04-2020
- Hawaii's Monitoring Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements A-09-19-01000
- National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded in 2019 OEI-07-20-00180
09-03-2020
- Medicare Hospital Provider Compliance Audit: Flagstaff Medical Center A-07-18-05112
- Updated COVID-19 FAQs
- Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group A-07-19-02822
09-02-2020
- CMS Generally Met Requirements for the DMEPOS Competitive Bidding Program Round 1 Recompete A-05-16-00051
- Tribal Health Programs: Concerns About Background Verifications for Staff Working With Indian Children A-01-20-01500
09-01-2020
- Indiana's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 17 of 30 Providers Reviewed A-05-19-00012
- Michigan Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00017
- Illinois Claimed Unallowable Telemedicine Payments A-05-18-00028
- Indiana Paid $3.5 Million for Medicaid Nonemergency Medical Transport Claims That Did Not Comply With Federal and State Requirements A-05-18-00043
August 2020
08-31-2020
08-28-2020
- Updated: Work Plan
- Texas Relied on Impermissible Provider-Related Donations To Fund the State Share of the Medicaid Delivery System Reform Incentive Payment Program A-06-17-09002
08-27-2020
08-26-2020
- CMS's Encounter Data Lack Essential Information That Medicare Advantage Organizations Have the Ability to Collect OEI-03-19-00430
- Updated: Work Plan
08-25-2020
08-20-2020
- Updated: Fraud Risk Indicator
- New Jersey Did Not Ensure That Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries Residing in Nursing Facilities Were Always Properly Investigated and Reported A-02-18-01006
08-18-2020
- Nebraska Claimed Unallowable School-Based Administrative Costs Because of Improper Coding of Random Moment Timestudy Responses A-07-19-03234
- Medicare Home Health Agency Provider Compliance Audit: Mission Home Health of San Diego, Inc. A-09-18-03008
08-17-2020
- Opioid Use in Medicare Part D Continued To Decline in 2019, but Vigilance Is Needed as COVID-19 Raises New Concerns OEI-02-20-00320
- Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2020 OEI-03-20-00060
- Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2018 Average Sales Prices OEI-03-20-00130
- Updated: Work Plan
08-14-2020
08-12-2020
- Medicare Home Health Agency Provider Compliance Audit: Condado Home Care Program, Inc. A-02-17-01022
- Visionquest Industries, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03010
08-11-2020
- OIG's Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs
08-10-2020
08-07-2020
08-06-2020
- Updated: Corporate Integrity Agreements
- Some Nursing Homes' Reported Staffing Levels in 2018 Raise Concerns; Consumer Transparency Could Be Increased OEI-04-18-00450
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2019 A-18-20-11300
- LEIE Database Updated with July 2020 Exclusions and Reinstatements
08-05-2020
08-04-2020
08-03-2020
July 2020
07-31-2020
07-30-2020
- Kansas Did Not Ensure That Group Homes for Children in Foster Care Complied With All State Health and Safety Requirements A-07-19-06087
- UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- Factsheet: Ohio's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-05-19-00036
07-29-2020
07-28-2020
07-27-2020
07-24-2020
- Updated Corporate Integrity Agreements
- Alaska Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-09-19-02001
- Advisory Opinion 20-04 (regarding a charitable organization's proposal to purchase or receive donations of unpaid medical debt owed by qualifying patients from certain types of health care providers a
- Utah's Monitoring Process Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements A-07-19-06085
- On-Site Psychological Services, P.C.: Audit of Medicare Payments for Psychotherapy Services A-02-19-01012
07-23-2020
- HRSA's Monitoring Did Not Always Ensure Health Centers' Compliance With Federal Requirements for HRSA's Access Increases In Mental Health and Substance Abuse Services Supplemental Grant Funding A-02-1
- CMS Could Have Saved $192 Million by Targeting Home Health Claims for Review With Visits Slightly Above the Threshold That Triggers a Higher Medicare Payment A-09-18-03031
07-22-2020
07-16-2020
- Ohio Did Not Ensure the Accuracy and Completeness of Psychotropic and Opioid Medication Information Recorded in Its Child Welfare Information System for Children in Foster Care A-05-18-00007
- CMS Did Not Administer and Manage Strategic Communications Services Contracts in Accordance With Federal Requirements A-12-19-20003
07-15-2020
- Updated: Work Plan
- Updated Corporate Integrity Agreements
- Hospitals Overbilled Medicare $1 Billion by Incorrectly Assigning Severe Malnutrition Diagnosis Codes to Inpatient Hospital Claims A-03-17-00010
07-14-2020
07-13-2020
- Updated Corporate Integrity Agreements
- Texas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-04003
07-10-2020
- LEIE Database Updated with June 2020 Exclusions and Reinstatements
- Sharon Baptist Head Start Claimed Unallowable Rent and Failed To Return Embezzled Funds A-02-17-02003
07-09-2020
07-08-2020
- Loophole in Drug Payment Rule Continues To Cost Medicare and Beneficiaries Hundreds of Millions of Dollars OEI-BL-20-00100
- Freedom Orthotics, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03012
- Updated: Fraud Risk Indicator
- Updated: Provider Self-Disclosure Settlements
07-07-2020
- 2019 Performance Data for the Senior Medicare Patrol Projects OEI-02-20-00150
- Updated Corporate Integrity Agreements
07-02-2020
07-01-2020
June 2020
06-30-2020
06-26-2020
- Updated: Fraud Risk Indicator
- Hawaii Medicaid Fraud Control Unit: 2019 Onsite Review OEI-06-19-00110
06-23-2020
06-19-2020
06-18-2020
- View a timeline detailing OIG's national review of the UAC Program
- The Office of Refugee Resettlement's Incident Reporting System Is Not Effectively Capturing Data To Assist Its Efforts To Ensure the Safety of Minors in HHS Custody OEI-09-18-00430
- Press Release: HHS-OIG: Significant Incidents Involving Unaccompanied Children Not Effectively Captured in Reporting System; Facility Physical Security Inspection Checklists Need Improvement
- Unaccompanied Alien Children Program Care Provider Facilities Do Not Include All Required Security Measures in Their Checklists OEI-05-19-00210
06-15-2020
06-10-2020
- LEIE Database Updated with May 2020 Exclusions and Reinstatements
- Updated Provider Self-Disclosure Settlements
06-09-2020
06-08-2020
- Medicare Hospital Provider Compliance Audit: The Ohio State University Hospital A-05-18-00042
- Texas Telemedicine Services Were Provided in Accordance with State Requirements A-06-18-05001
06-05-2020
06-04-2020
06-03-2020
- New Jersey Did Not Ensure That Its Managed Care Organizations Adequately Assessed and Covered Medicaid Beneficiaries' Needs for Long-Term Services and Supports A-02-17-01018
- The National Cancer Institute Needs To Strengthen Procedures in Its Pre-Award Process To Assess Risk for Higher Risk Applicants A-03-19-03004
06-01-2020
May 2020
05-28-2020
05-27-2020
05-26-2020
- COVID-19 Response Strategic Plan
- Opening Statement for Christi Grimm , Principal Deputy Inspector General, Office of Inspector General, U.S. House Committee on Oversight and Reform: Oversight Related to Coronavirus Response Efforts
05-22-2020
05-14-2020
05-13-2020
05-12-2020
05-08-2020
- UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- HHS Operating Division Needs to Improve Security Controls to More Effectively Prevent Cyberattacks A-18-18-08400
- LEIE Database Updated with April 2020 Exclusions and Reinstatements
05-07-2020
- HHS OIG Toolkits for Calculating Opioid Levels and Identifying Patients At Risk of Misuse or Overdose
- Updated Provider Self-Disclosure Settlements
- Medicare Part D Beneficiaries at Serious Risk of Opioid Misuse or Overdose: A Closer Look OEI-02-19-00130
05-06-2020
05-05-2020
- Medicare Made $11.7 Million in Overpayments for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays A-01-17-00508
- Illinois' Monitoring Did Not Ensure Childcare Provider Compliance With State Criminal Background Check Requirements at 12 of 30 Providers Reviewed A-05-19-00016
05-04-2020
05-01-2020
- UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
- North Carolina Received $30 Million in Excess Federal Funds Related to Improperly Claimed Health Home Expenditures A-04-18-00120
April 2020
04-30-2020
04-28-2020
04-24-2020
04-23-2020
04-22-2020
- Recommendation Followup: Michigan Did Not Report and Refund the Full Federal Share of Medicaid Overpayments A-05-18-00022
- Grand Desert Psychiatric Services: Audit of Medicare Payments for Psychotherapy Services A-09-19-03018
04-21-2020
- Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00587
- HHS Operating Division Needs to Improve Information Technology Continuity Planning A-18-18-04005
- Grants, Contracts, and Other Agreements: Fraud and Abuse; Information Blocking; Office of Inspector General's Civil Money Penalty Rules Press Release: OIG proposes rule for civil money penalties for i
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs A-07-20-00589
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Pension Costs A-07-20-00588
- Palmetto Government Benefits Administrator, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00586
04-20-2020
- Cape Cod Child Development Program Did Not Meet Its Head Start Non-Federal Share Obligations A-01-19-02500
- Updated Corporate Integrity Agreements
04-17-2020
04-15-2020
- 96 Percent of South Carolina's Medicaid Fee-for-Service Telemedicine Payments Were Insufficiently Documented or Otherwise Unallowable A-04-18-00122
- Mississippi Needs To Improve Oversight of Its Child Care Payment Program A-07-18-04111
- Updated Corporate Integrity Agreements
- Updated: Work Plan
04-14-2020
- Medicare Home Health Agency Provider Compliance Audit: Residential Home Health A-05-16-00063
- Updated Corporate Integrity Agreements
04-13-2020
- Most Indian Health Service Purchased/Referred Care Program Claims Were Not Reviewed, Approved, and Paid in Accordance With Federal Requirements
- An Estimated 87 Percent of Inpatient Psychiatric Facility Claims With Outlier Payments Did Not Meet Medicare's Medical Necessity or Documentation Requirements A-01-16-00508
04-10-2020
04-09-2020
- New York Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-02-18-01016
- Updated Fraud Risk Indicator
- Iowa Inadequately Monitored Its Medicaid Health Home Providers, Resulting in Tens of Millions in Improperly Claimed Reimbursement A-07-18-04109
04-07-2020
- Updated Provider Self-Disclosure Settlements
- Updated: Work Plan
- Updated Corporate Integrity Agreements
- Updated CIA Reportable Events
04-06-2020
- The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2018 in Accordance With Federal Requirements A-04-19-04072
- New Hampshire's Monitoring Did Not Ensure Childcare Provider Compliance With State Criminal Background Check Requirements at 21 of 30 Providers Reviewed A-01-18-02504
- Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020 OEI-06-20-00300
- Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2019 A-18-19-11200
04-03-2020
- NIH Has Acted To Protect Confidential Information Handled by Peer Reviewers, But It Could Do More OEI-05-19-00240
- OIG Policy Statement Regarding Application of Certain Administrative Enforcement Authorities Due to Declaration of Coronavirus Disease 2019 (COVID-19) Outbreak in the United States as a National Emerg
- FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
04-01-2020
- Twenty-Three States Reported Allowing Unenrolled Providers To Serve Medicaid Beneficiaries OEI-05-19-00060
- States Could Do More To Prevent Terminated Providers From Serving Medicaid Beneficiaries OEI-03-19-00070
March 2020
03-31-2020
- Medicare Hospital Provider Compliance Audit: Forbes Hospital A-03-18-00005
- Updated CIA Reportable Events
- New York's Oversight of Medicaid Managed Care Organizations Did Not Ensure Providers Complied With Health and Safety Requirements at 18 of 20 Adult Day Care Facilities Reviewed A-02-18-01027
- Updated Civil Monetary Penalties and Affirmative Exclusions
03-30-2020
- OIG Strategic Plan 2020–2025
- Iowa Did Not Comply With Federal and State Requirements for Major Incidents Involving Medicaid Members With Developmental Disabilities A-07-18-06081
- Message from leadership on minimizing burdens on providers
03-27-2020
- Risk Assessment of HHS Grant Closeout Procedures A-04-19-08072
- Updated Corporate Integrity Agreements
- At A Glance: Medicaid Fraud Control Units Fiscal Year 2019 Annual Report
- Medicare Dialysis Services Provider Compliance Review: Bio-Medical Applications of Arecibo, Inc. A-02-17-01016
03-26-2020
- Most of the Non-Newly Eligible Beneficiaries for Whom Colorado Made Medicaid Payments Met Federal and State Requirements, but Documentation Supporting That All Eligibility Requirements Were Verified P
- Office of Counsel inquiries should be directed to officeofcounsel@oig.hhs.gov
03-24-2020
- Florida Made Almost $4 Million in Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid ID Numbers A-04-18-07080
- FAQ: Waiving Telehealth Cost-Sharing During COVID-19 Outbreak
- Updated Corporate Integrity Agreements
03-23-2020
- Montana Medicaid Fraud Control Unit: 2019 Onsite Inspection OEI-12-19-00170
- Updated: Work Plan
- Fraud Alert: COVID-19 Scams
03-20-2020
03-19-2020
03-18-2020
03-17-2020
- Waiving Telehealth Cost-Sharing During COVID-19 Outbreak Telehealth Factsheet Telehealth Frequently Asked Questions
- Missouri Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-07-18-03230
03-16-2020
- The National Institutes of Health Has Controls to Mitigate the Risk That Grantees Receive Duplicate Grant Funding A-02-19-02002
- Updated Corporate Integrity Agreements
- Updated Civil Monetary Penalties and Affirmative Exclusions
- Updated: Work Plan
03-11-2020
03-10-2020
- LEIE Database Updated with February 2020 Exclusions and Reinstatements
- Factsheet: Kentucky's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-04-19-02022
- SAMHSA's Oversight of Accreditation Bodies for Opioid Treatment Programs Did Not Comply With Some Federal Requirements A-09-18-01007
- Key Medicare Tools To Safeguard Against Pharmacy Fraud and Inappropriate Billing Do Not Apply to Part D OEI-02-15-00440
- Florida Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-18-08065
03-09-2020
03-05-2020
- Communication and Management Challenges Impeded HHS's Response to the Zero-Tolerance Policy OEI-BL-18-00510
- Press Release: HHS OIG: Communication and Management Challenges Impeded HHS's Response to Zero-Tolerance Policy
03-04-2020
- Medicare Hospital Provider Compliance Audit: Saint Francis Health Center A-07-17-05102
- Updated Provider Self-Disclosure Settlements
03-03-2020
- New Mexico's Monitoring of Childcare Providers Generally Ensured Provider Compliance With State Criminal Background Check Requirements at 30 Childcare Providers Reviewed A-06-19-07001
- The Centers for Medicare & Medicaid Services Did Not Identify and Report Potential Antideficiency Act Violations for 12 Contracts Used To Establish the Federal Marketplace Under the Affordable Care Ac
- Updated Corporate Integrity Agreements
03-02-2020
- CHI St. Vincent Infirmary: Audit of Outpatient Outlier Payments A-06-16-01002
- National Institutes of Health Had Information Technology Control Weaknesses Surrounding Its Electronic Health Record System A-18-19-06003
February 2020
02-27-2020
02-26-2020
- Ownership—But Not Physical Movement—of Selected Drugs Can Be Traced Through the Supply Chain OEI-05-17-00460
- New York Made Unallowable Payments Totaling More Than $10 Million for Managed Care Beneficiaries Assigned Multiple Medicaid Identification Numbers A-02-18-01020
- New York Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-02-18-01011
02-24-2020
02-21-2020
02-20-2020
- Michigan Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-05-17-00048
02-18-2020
- Updated: Work Plan
- Opportunities for Williamson and Burnet Counties Had Ineffective Accounting Controls and Used Unapproved or Questionable Cost Allocation Methods A-06-18-02002
02-14-2020
- The Majority of Providers Reviewed Used Medicare Part D Eligibility Verification Transactions for Potentially Inappropriate Purposes A-05-17-00020
- Georgia's Monitoring of Childcare Providers Ensured Provider Compliance With State Criminal Background Check Requirements A-04-19-03580
02-13-2020
- The Indiana State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-05-19-00007
- Wateree Community Actions, Inc., Made Improvements but Still Requires Monitoring A-04-19-08069
- New York Followed Its Approved Methodology for Claiming Enhanced Medicaid Reimbursement Under the Community First Choice Option A-02-17-01015
02-12-2020
02-10-2020
- Life Safety and Emergency Preparedness Deficiencies Found at 18 of 20 Texas Nursing Homes A-06-19-08001
- FY 2021 Congressional Budget Justification
- LEIE Database Updated with January 2020 Exclusions and Reinstatements
- Job Opening: Associate Counsel for Exclusions (Washington, DC)
02-06-2020
- New York Claimed Tens of Millions of Dollars for Opioid Treatment Program Services That Did Not Comply With Medicaid Requirements Intended To Ensure the Quality of Care Provided to Beneficiaries A-02-
- Updated Provider Self-Disclosure Settlements
02-04-2020
02-03-2020
January 2020
01-30-2020
01-29-2020
01-27-2020
- Tennessee's Monitoring Ensured Compliance With Criminal Background Check Requirements at 28 of the 30 Childcare Providers Reviewed A-04-19-02023
- The National Institutes of Health Submitted OIG Clearance Documents for Just Over One-Half of Its Audit Recommendations, and the Remaining 225 Recommendations Were Unresolved as of September 30, 2016
- CMS's Implementation of a 2014 Policy Change Resulted in Improvements in the Reporting of Coverage Gap Discounts Under Medicare Part D A-07-16-06067
01-24-2020
01-23-2020
01-22-2020
- Pennsylvania Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-03-17-00202
- Updated Corporate Integrity Agreements
- Updated Civil Monetary Penalties and Affirmative Exclusions
01-17-2020
- Florida's Refugee Medical Assistance Payments Were Generally Allowable A-04-18-02010
- Novitas Solutions, Inc. Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances A-06-17-04002
- Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Rel
01-16-2020
01-15-2020
01-14-2020
01-13-2020
01-10-2020
- LEIE Database Updated with December 2019 Exclusions and Reinstatements
- Updated Provider Self-Disclosure Settlements