What's New

December 2024

12-31-2024

• Advisory Opinion 24-13 Favorable opinion regarding assistance for certain travel, lodging, meals, and associated expenses for qualifying patients receiving a cell therapy product manufactured by a pha

12-26-2024

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UCare Minnesota (Contract H2459) Submitted to CMS A-07-22-01209
• Medicare Advantage Compliance Audit of Specific Diagnosis Codes Blue Care Network of Michigan (Contract H5883) Submitted to CMS A-06-20-02000
• ICAP at Columbia University Generally Managed Its PEPFAR Expenditures Appropriately but Lacked a Robust Financial Management System A-04-20-01020

12-23-2024

• Total Medicare Part B Spending on Lab Tests Decreased in 2023, Driven in Part by Less Spending on COVID-19 Tests OEI-09-24-00350
• Medicare Home Health Agency Provider Compliance Audit: Bridge Home Health A-05-23-00017
• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Triple-S Advantage, Inc., (Contract H5774) Submitted to CMS A-04-21-07095

12-20-2024

• Some Selected Skilled Nursing Facilities Did Not Comply With Medicare Requirements for Reporting Related-Party Costs A-07-21-02836
• Updated: CMP and Affirmative Exclusions/EMTALA
• Some HHS Requirements for Vetting Mobile Apps Were Not Followed Prior to the Release of the AHRQ Question Builder App A-18-22-09008
• Providers Used Medicare Part D Eligibility Verification Transactions for Permissible Purposes A-05-22-00022
• Updated: Corporate Integrity Agreements

12-19-2024

• Twelve Selected States Did Not Accurately Calculate the Federal Share of Medicaid Collections Subject to the Increased COVID-19 Federal Medical Assistance Percentages A-06-23-09002
• Updated: Corporate Integrity Agreements
• Medicaid Gross Spending on 10 Selected Diabetes and 2 Selected Weight Loss Drugs Totaled More Than $9 Billion in 2023, an Increase of 540 Percent From 2019 A-05-24-00016
• Indiana Made at Least $56 Million in Improper Fee-for-Service Medicaid Payments for Applied Behavior Analysis Provided to Children Diagnosed With Autism A-09-22-02002

12-18-2024

• Summary Report of Prior Office of Inspector General Cyber Threat Hunt Audits of Eight HHS Operating Division Networks A-18-22-07002

12-17-2024

• Advisory Opinion 24-11 Favorable opinion regarding the provision of meningococcal vaccinations to eligible patients prescribed one of two drugs that carry a heightened risk of contracting meningococca
• Updated: Work Plan
• Advisory Opinion 24-12 Favorable opinion regarding a program to sponsor genetic testing, related genetic counseling, and disease-state awareness education regarding certain hereditary conditions that

12-16-2024

• Update: Xolair Prefilled Syringes Likely Meet Part B Coverage Criteria OEI-BL-24-00440
• Updated: Corporate Integrity Agreements

12-13-2024

• Updated: Corporate Integrity Agreements

12-12-2024

• Advisory Opinion 24-10 Favorable opinion regarding a dental supplies distributor’s proposed expansion of its existing customer loyalty program for purchases of dental-related items and services.
• Updated: CMP and Affirmative Exclusions

12-10-2024

• Featured Topic: PHHS Grants and Contracts
• LEIE Database Updated with November 2024 Exclusions and Reinstatements

12-06-2024

• Updated: Fraud Self-Disclosures
• FY 2023 Health Care Fraud and Abuse Control Program Report
• Updated: Corporate Integrity Agreements
• Updated: CMP and Affirmative Exclusions/EMTALA

12-05-2024

• Findings of Whistleblower Retaliation by Administration for Strategic Preparedness and Response Management Official

12-04-2024

• HHS-OIG's Efforts Result in $7.13 Billion in Expected Recoveries and Receivables, According to Fall 2024 Semiannual Report
• Fall 2024 Semiannual Report to Congress
• CGS Administrators, LLC, Did Not Reopen and Recalculate Most Selected Hospices’ Caps for Years Prior to 2020 A-06-23-09003

12-03-2024

• Nonprofit and Government-Owned Nursing Homes Generally Complied With Federal Requirements Regarding the Infection Preventionist Position A-01-24-00002
• Updated: Corporate Integrity Agreements
• The Organ Procurement and Transplantation Network IT System’s Cybersecurity Controls Were Partially Effective and Improvements Are Needed A-18-22-03400

November 2024

11-29-2024

• Texas Generally Claimed Medicaid Reimbursement for Fee-for-Service Inpatient Hospital Claims With Malnutrition Diagnosis Codes in Accordance with Federal and State Requirements A-06-22-04002
• Selected Home Health Agencies Complied With Terms and Conditions and Federal Requirements for Provider Relief Fund Payments A-01-22-00503

11-27-2024

• Puerto Rico Did Not Designate a Medicaid Contracts Oversight Lead in a Timely Manner and Certified Contracts That Were Noncompliant A-02-24-01002

11-26-2024

• CDC's and SAMHSA's Processes for and Challenges With Compiling Data for the National Drug Control Assessment A-03-24-00353

11-25-2024

• Advisory Opinion 24-09 Favorable opinion regarding: a proposal for a municipal corporation to begin billing patients' insurance plans—and waiving any patient cost-sharing amounts—for treatment-in-plac
• The Office for Civil Rights Should Enhance Its HIPAA Audit Program to Enforce HIPAA Requirements and Improve the Protection of Electronic Protected Health Information A-18-21-08014

11-20-2024

• Nursing Facility Industry Segment-Specific Compliance Program Guidance

11-19-2024

• Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2024 A-18-24-11200

11-18-2024

• Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2024 OEI-03-25-00010
• 2024 Top Management & Performance Challenges Facing HHS
• Medicare Improperly Paid Acute-Care Hospitals an Estimated $190 Million Over 5 Years for Outpatient Services Provided to Hospice Enrollees A-09-23-03024
• Job Opening: FOIA General Attorney (Associate Counsel)

11-15-2024

• Washington State's Oversight Could Better Ensure That Adult Family Homes Comply With Health and Safety and Administrative Requirements A-09-23-02002
• Updated: Work Plan
• Updated: Corporate Integrity Agreements
• Utah Generally Operated Its Medicaid Estate Recovery Program in Accordance With Requirements and in a Cost Effective Manner, but Utah Did Not Have Formal Written Procedures A-07-23-03257

11-14-2024

• Updated: Heightened Scrutiny
• Maine Did Not Comply With Screening, Assessment, and Investigation Requirements for Responding to Reports of Child Abuse and Neglect A-01-23-02500
• Seven of Thirty Hospices Reviewed Did Not Comply or May Not Have Complied With Terms and Conditions and Federal Requirements for Provider Relief Fund Payments A-02-22-01014
• National Government Services, Inc., Reopened and Corrected Cost Report Final Settlements With Obvious Errors To Collect Overpayments Made to Medicare Providers A-06-24-05000

11-13-2024

• Findings of Retaliation by Management Official in the HHS Office of the Chief Information Officer

11-08-2024

• Updated: CMP and Affirmative Exclusions
• LEIE Database Updated with October 2024 Exclusions and Reinstatements
• Not All Selected Hospitals Complied With the Hospital Price Transparency Rule A-07-22-06108
• Updated: Fraud Self-Disclosures

11-07-2024

• Updated: Corporate Integrity Agreements
• National Background Check Program for Long-Term Care Providers: A Final Assessment OEI-07-24-00100

11-01-2024

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

October 2024

10-31-2024

• Updated: Corporate Integrity Agreements
• Job Opening: Administrative and Civil Remedies Branch (ACRB) and Industry Guidance Branch (IGB) Attorney

10-29-2024

• ASPR Established Adequate Controls for Maintaining Physical Security and Inventory Records at Stockpile Site B A-04-24-02046

10-25-2024

• Massachusetts Could Better Ensure That Intermediate Care Facilities for Individuals With Intellectual Disabilities Comply With Federal Requirements for Life Safety and Emergency Preparedness A-01-24-0
• California Used CARES Act Funds for Unallowable Nutrition Services Program Expenditures A-06-22-01004

10-24-2024

• Medicare Advantage: Plans Still Using Questionable Health Risk Assessments to Boost Medicare Payments by Billions OEI-03-23-00380

10-22-2024

• Updated: CMP and Affirmative Exclusions
• Medicare Part D Paid Millions for Drugs for Which Payment Was Available Under the Medicare Part A Skilled Nursing Facility Benefit A-09-21-03008

10-17-2024

• 2024 Top Unimplemented Recommendations

10-16-2024

• Employee Profile: Kofi Ansah-Brew

10-15-2024

• Updated: Work Plan

10-11-2024

• Updated: Annual Inflation Updates to the Annual Cap on Patient Engagement Tools and Supports Under 42 CFR § 1001.952(hh)
• Updated: Fraud Risk and Heightened Scrutiny Q1-Q4

10-10-2024

• Finding of Retaliation by Administration Children and Families Grantee
• HHS-OIG: Strengthening Cybersecurity in Health Care
• LEIE Database Updated with September 2024 Exclusions and Reinstatements

10-09-2024

• Massachusetts Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-01-23-00003

10-08-2024

• Updated: Fraud Self-Disclosures

10-04-2024

• Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2023 A-18-24-11300
• HHS Continues to Make Progress Toward Compliance With the Geospatial Data Act A-18-24-03500

10-03-2024

• New Strategic Plan: Safeguarding the Integrity of HHS Grants and Contracts

10-02-2024

• States Could Better Leverage Coverage and Access Requirements To Promote Maternal Health Care Access in Medicaid Managed Care OEI-05-22-00330

September 2024

09-30-2024

• ASPR Established Adequate Controls for Maintaining Physical Security Over Stockpile Site A, but Some Inventory Discrepancies Were Identified A-04-24-02044

09-27-2024

• Featured Article: HHS-OIG's Efforts to Address the Opioid Epidemic

09-26-2024

• Gallup Indian Medical Center—an IHS-Operated Health Facility—Did Not Timely Conduct Required Background Checks of Staff and Supervise Certain Staff A-02-23-02006
• Medicare Advantage Compliance Audit of Diagnosis Codes That EmblemHealth (Contract H3330) Submitted to CMS A-06-18-02001

09-25-2024

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Humana Health Plan, Inc. (Contract H2649) Submitted to CMS A-02-22-01001
• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HealthAssurance, Pennsylvania, Inc. (Contract H5522) Submitted to CMS A-05-22-00020

09-24-2024

• Systemic and Operational Challenges Hinder Efforts to Ensure HIV Care for Medicaid Enrollees OEI-05-22-00242
• Additional Oversight of Remote Patient Monitoring in Medicare Is Needed OEI-02-23-00260

09-23-2024

• Medicare and Medicaid Enrollees in Many High-Need Areas May Lack Access to Medications for Opioid Use Disorder OEI-BL-23-00160

09-19-2024

• CMS Recovered Medicare Payments to Providers Under the COVID-19 Accelerated and Advance Payments Program in Compliance With Federal Requirements A-05-23-00005

09-18-2024

• Revised Medicaid Fraud Control Unit Performance Standards

09-17-2024

• Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2022 Average Sales Prices OEI-03-24-00080

09-16-2024

• Updated: Work Plan

09-13-2024

• Advisory Opinion 24-08 Unfavorable advisory opinion regarding an entity's proposal to share a percentage of its savings with certain groups to which it provides coverage through Employer Group Waiver
• Novitas Solutions, Inc., Reopened and Corrected Cost Report Final Settlements With Obvious Errors To Collect Overpayments Made to Medicare Providers A-06-23-05001

09-12-2024

• Updated: Corporate Integrity Agreements

09-11-2024

• Updated: Fraud Self-Disclosures
• Featured Topic: The Emergency Medical Treatment and Labor Act (EMTALA)
• Spring 2025 OIG Health Care Fraud and Abuse Legal Internship

09-10-2024

• LEIE Database Updated with August 2024 Exclusions and Reinstatements
• Most Children in Foster Care Did Not Receive Credit Checks and Assistance OEI-07-22-00510

09-09-2024

• Employee Profile: Amanda Sutter

09-05-2024

• New Mexico Did Not Ensure Attendants Were Qualified To Provide Personal Care Services, Putting Medicaid Enrollees at Risk A-06-22-02000

09-03-2024

• Massachusetts Opioid Treatment Program Services Met Many of the Federal and State Requirements A-01-23-00002

August 2024

08-29-2024

• Utah Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements A-07-24-07013
• South Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-22-07010

08-23-2024

• Advisory Opinion 24-07 Favorable opinion regarding a proposed patient assistance program operated by a nonprofit grant-making organization.

08-21-2024

• Kansas's Implemented Electronic Visit Verification System Could Be Improved A-07-23-03255

08-20-2024

• Certain For-Profit Nursing Homes May Not Have Complied With Federal Requirements Regarding the Infection Preventionist Position A-01-22-00001

08-19-2024

• Illinois MMIS and E&E System Had Adequate Security Controls in Place, but Some Improvements Are Needed A-18-22-09009

08-16-2024

• Updated: CMP and Affirmative Exclusions
• Updated: Corporate Integrity Agreements

08-15-2024

• Updated: Work Plan
• Massachusetts Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements A-02-24-01001

08-14-2024

• Medicare Advantage Compliance Audit of Diagnosis Codes That MMM Healthcare, LLC, (Contract H4003) Submitted to CMS A-04-20-07090

08-13-2024

• Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2024 OEI-03-24-00070
• Office of Inspector General's Partnership With the Ohio Auditor of State: Auditor of State's Report Ohio Department of Medicaid: The Cost of Concurrent Enrollment A-09-23-02004

08-12-2024

• Medicare Improperly Paid Hospitals an Estimated $79 Million for Enrollees Who Had Received Mechanical Ventilation A-09-22-03002
• Updated: Fraud Self-Disclosures

08-09-2024

• Medicare and Some Enrollees Paid Substantially More When Stelara Was Covered Under Part D Versus Part B OEI-BL-19-00500
• LEIE Database Updated with July 2024 Exclusions and Reinstatements

08-07-2024

• Opioid Treatment Programs in Washington State Did Not Fully Comply With Federal and State Requirements, Which May Have Put Medicaid Enrollees at Risk for Poor Treatment Outcomes A-09-21-02001
• Updated: Corporate Integrity Agreements

08-05-2024

• CDC Provided Oversight and Assistance, but Recipients Faced Challenges in Implementing a COVID-19 Vaccine Confidence Strategy A-06-22-04004
• The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2023 in Accordance With Federal Requirements A-04-24-02045

08-02-2024

• Alaska Medicaid Fraud Control Unit: 2023 Inspection OEI-07-23-00240

July 2024

07-31-2024

• Updated: Fraud Risk and Heightened Scrutiny Q1-Q3

07-29-2024

• West Virginia Medicaid Fraud Control Unit: 2023 Inspection OEI-09-23-00390
• Employee Profile: Melissa C. Tucker
• Heluna Health May Not Have Used California's CDC COVID-19 Funds in Accordance With Award Requirements A-04-22-02037

07-26-2024

• California Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State A-05-23-00008

07-23-2024

• Advisory Opinion 24-06 Unfavorable opinion regarding proposed assistance for fertility services for qualifying patients receiving a gene therapy treatment developed by a biotechnology company.

07-22-2024

• HHS Office of the Secretary Needs to Improve Key Security Controls to Better Protect Certain Cloud Information Systems A-18-22-08018
• Advisory Opinion 24-05 Favorable in part and unfavorable in part opinion regarding proposed assistance for: (i) travel, lodging, meals, and associated expenses; and (ii) fertility preservation service
• Updated: Corporate Integrity Agreements

07-16-2024

• ASPR Did Not Consistently Comply With Federal Requirements for Awarding Research and Development Contracts A-03-20-03003
• Job Opening: Schedule A Persons with Disability Opportunity: Criminal Investigator GL-1811-09 (Closes July 22)
• Updated: Corporate Integrity Agreements

07-15-2024

• Updated: Work Plan

07-12-2024

• Updated: Corporate Integrity Agreements

07-11-2024

• Updated: Corporate Integrity Agreements

07-10-2024

• LEIE Database Updated with June 2024 Exclusions and Reinstatements

07-08-2024

• NEW HHS-OIG Impact Brief: Medicare Advantage Fraud
• Updated FAQ: General Questions Regarding Certain Fraud and Abuse Authorities

07-05-2024

• Updated: Fraud Self-Disclosures
• Updated: Grant and Contractor Fraud Self-Disclosures

07-02-2024

• 2023 Performance Data for the Senior Medicare Patrol Projects OEI-02-24-00260

07-01-2024

• Updated: CMP and Affirmative Exclusions

June 2024

06-28-2024

• Part D Plans Generally Include Drugs Commonly Used by Dual-Eligible Enrollees: 2024 OEI-05-24-00210
• Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2023 A-18-23-11200

06-27-2024

• 2024 Nationwide Health Care Fraud Enforcement Action
• The National Institutes of Health Has Made Progress But Could Further Improve Its Closeout Process for Grants and Similar Awards A-04-23-08097
• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Independent Health Association, Inc. (Contract H3362) Submitted to CMS A-07-19-01194

06-26-2024

• Many States Lack Information To Monitor Maltreatment in Residential Facilities for Children in Foster Care OEI-07-22-00530

06-25-2024

• North Carolina Did Not Report and Return All Medicaid Overpayments for the State's Medicaid Fraud Control Unit Cases A-06-23-04004

06-20-2024

• NIH Did Not Close Contracts in Accordance With Federal Requirements, Resulting in the Increased Risk of Fraud, Waste, and Abuse A-04-23-03585
• Advisory Opinion 24-04 Favorable opinion regarding: (i) a limited-time program to refund, waive, or delay requiring receipt of payment for a drug in the event of an insurance reimbursement denial or d

06-18-2024

• Updated: Corporate Integrity Agreements

06-17-2024

• Updated: Work Plan
• Advisory Opinion 24-03 Favorable opinion regarding assistance, including travel, lodging, meals, and associated expenses, provided by a pharmaceutical manufacturer to qualifying patients receiving its

06-13-2024

• CMS Could Strengthen Program Safeguards To Prevent and Detect Improper Medicare Payments for Short Inpatient Stays A-09-21-03022
• The Food and Drug Administration's Inspection and Recall Process Should Be Improved To Ensure the Safety of the Infant Formula Supply A-01-22-01502

06-11-2024

• Updated: Corporate Integrity Agreements

06-10-2024

• LEIE Database Updated with May 2024 Exclusions and Reinstatements
• Washington Medicaid Fraud Control Unit: 2023 Inspection OEI-09-23-00230

06-07-2024

• Updated: Fraud Self-Disclosures

06-04-2024

• Updated: Corporate Integrity Agreements

06-03-2024

• HHS-OIG Reports Nearly $3 Billion in Expected Recoveries in Newly Streamlined Semiannual Report
• Spring 2024 Semiannual Report to Congress
• OpEd: Pandemic lessons must spur federal action to protect nursing home residents

May 2024

05-30-2024

• Fall 2024 OIG Health Care Fraud and Abuse Legal Internship

05-29-2024

• Medicare Remains Vulnerable to Fraud, Waste, and Abuse Related to Off-the-Shelf Orthotic Braces, Which May Result in Improper Payments and Impact the Health of Enrollees A-09-21-03019

05-28-2024

• Plans and Enrollment Often Fell Short for Underrepresented Groups in a Sample of NIH-Funded Clinical Trials OEI-01-21-00320

05-23-2024

• Medicaid Managed Care: States Do Not Consistently Define or Validate Paid Amount Data for Drug Claims OEI-03-20-00560

05-22-2024

• Selected CDC Racial and Ethnic Approaches to Community Health Program Recipients Generally Complied With Federal Requirements But Did Not Meet All Targets and Charged Some Unallowable Costs A-02-22-02
• Wanted Fugitive: Dr. Yogeshwar Singh "Garry" Gill

05-21-2024

• California Improperly Claimed $52.7 Million in Federal Medicaid Reimbursement for Capitation Payments Made on Behalf of Noncitizens With Unsatisfactory Immigration Status A-09-22-02004

05-20-2024

• Updated: Corporate Integrity Agreements Office of Counsel
• Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for the Fiscal Ye
• Job Opening: Special Policy Advisor/Reviewing Official

05-16-2024

• Employee Profile: Deputy Regional Inspector General Meridith Seife: Creative Problem Solving to Make Meaningful, Positive Change in People's Lives
• Updated: Corporate Integrity Agreements

05-15-2024

• Updated: Work Plan
• Colorado Did Not Report and Refund the Correct Federal Share of Medicaid-Related Overpayments for Some Cases Identified by the State's Program Integrity Section A-07-19-02816

05-14-2024

• New York Medical College Claimed Unallowable Grant Costs and Did Not Meet Certain Financial Conflict of Interest Requirements A-04-20-03583
• Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2023 OEI-03-24-00060

05-13-2024

• New Mexico Should Refund Almost $120 Million to the Federal Government for Medicaid Nursing Facility Level-of-Care Managed Care Capitated Payments A-06-20-09001
• Updated: CMP and Affirmative Exclusions

05-10-2024

• State Agencies Could Be Obtaining Hundreds of Millions in Additional Medicaid Rebates Associated With Physician-Administered Drugs A-07-23-06111
• LEIE Database Updated with April 2024 Exclusions and Reinstatements
• Potential Vulnerabilities in CMS Oversight of Medicare Add-on Payments for COVID-19 Tests Show That Oversight of Incentive Payments Could Be Improved A-09-22-03015

05-09-2024

• California Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements A-09-24-02001
• Updated: Corporate Integrity Agreements

05-08-2024

• Survey on the Role of Patient Selection Criteria in Ensuring Equitable Access to Kidney Transplantation
• Updated: Fraud Self-Disclosures
• Updated: Corporate Integrity Agreements

05-07-2024

• Office of Inspector General's Partnership With the State of Rhode Island, Office of the Auditor General: Medicaid Capitation Paid for Members Residing in Other States A-01-23-00001

05-02-2024

• Medicaid Enrollees May Not Be Screened for Intimate Partner Violence Because of Challenges Reported by Primary Care Clinicians OEI-03-21-00310

05-01-2024

• Updated: FY 2024 Q1-Q2 False Claims Act Settlements on the Risk Spectrum

April 2024

04-30-2024

• The Office of Intergovernmental and External Affairs' Purchase Card Program Did Not Comply With Federal and HHS Requirements A-03-22-00500

04-29-2024

• Florida Ensured That Nursing Homes Complied with Federal Background Check Requirements A-04-23-08100

04-25-2024

• West Virginia Lacked Effective Oversight of Its Opioid Response Grants A-06-22-01005

04-22-2024

• SENTENCED: Lilit Galstyan, Former HHS-OIG Fugitive

04-18-2024

• 28th Annual Compliance Institute - HHS-OIG Enforcement and Compliance Update

04-16-2024

• The Testimony of Inspector General Christi A. Grimm : Examining How Improper Payments Cost Taxpayers Billions and Weaken Medicare and Medicaid

04-15-2024

• Updated: Work Plan
• Updated: Corporate Integrity Agreements

04-11-2024

• Ohio Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements A-05-23-00019
• Advisory Opinion 24-02 Favorable opinion regarding patient assistance funds operated by a nonprofit, tax exempt charitable organization.

04-10-2024

• LEIE Database Updated with March 2024 Exclusions and Reinstatements
• Updated: Corporate Integrity Agreements .

04-05-2024

• Missouri May Not Have Used All CARES Act Funds for the Older Americans Act Nutrition Services Program in Accordance With Federal and State Requirements A-07-22-04130
• CMS Could Improve Its Procedures for Setting Medicare Clinical Diagnostic Laboratory Test Rates Under the Clinical Laboratory Fee Schedule for Future Public Health Emergencies A-01-21-00506
• Alabama MMIS and E&E System Security Controls Were Adequate, but Some Improvements Are Needed A-18-22-09010

04-04-2024

• Updated: Fraud Self-Disclosures
• New York Generally Identified and Corrected Duplicate Children's Health Insurance Plan Payments Made to Managed Care Organizations A-02-23-01017
• Alabama Claimed Federal Medicaid Reimbursement for Millions of Dollars in Targeted Case Management Services That Did Not Comply With Federal and State Requirements A-07-22-03253
• Updated: CIA Reportable Events
• Updated: CMP and Affirmative Exclusions
• Updated: Grant and Contractor Fraud Self-Disclosures

04-03-2024

• ACF Has Enhanced Some Cybersecurity Controls Over the Unaccompanied Children Portal and Data But Improvements Are Needed A-18-22-03200
• Nursing Home Residents With Endangering Behaviors and Mental Health Disorders May Be Vulnerable to Facility-Initiated Discharges OEI-01-18-00252
• Concerns Remain About Safeguards To Protect Residents During Facility-Initiated Discharges From Nursing Homes OEI-01-18-00251
• A Lack of Behavioral Health Providers in Medicare and Medicaid Impedes Enrollees' Access to Care OEI-02-22-00050

04-02-2024

• Administration for Children and Families Data Hosted in Certain Cloud Information Systems May Be at a High Risk of Compromise A-18-22-08020
• Fiscal Year 2018 and 2019 Biomedical Advanced Research and Development Authority Appropriations May Not Have Been Used for Their Intended Purpose in Accordance With Federal Requirements A-03-20-03002

04-01-2024

• IHS Did Not Coordinate Supply Service Center Operations Before and During the COVID-19 Pandemic and Should Consider Upgrading Supply Centers' Inventory Management Systems and Implementing Policies and
• New Jersey Significantly Improved Its Oversight of Medicaid Adult Partial Care Services Except for Those Provided Using Telehealth During the COVID-19 Public Health Emergency A-02-22-01007

March 2024

03-29-2024

• New Jersey Complied With Federal Regulations When Implementing Programs Under SAMHSA's Opioid Response Grants, But Did Not Meet Its Program Services Goals A-02-22-02002

03-28-2024

• CMS Did Not Ensure That Selected States Complied With Medicaid Managed Care Mental Health and Substance Use Disorder Parity Requirements A-02-22-01016

03-27-2024

• Delaware Made Capitation Payments to Medicaid Managed Care Organizations After Enrollees' Deaths A-03-22-00205
• The Thailand Ministry of Public Health Managed PEPFAR Funds According to Federal Regulations but Internal Controls Could Be Improved A-04-21-01021

03-26-2024

• HHS-OIG Cybersecurity Toolkit: Cybersecurity Considerations For HHS's Rapid Rollout of Information Systems

03-25-2024

• Updated: CMP and Affirmative Exclusions

03-21-2024

• New Video: HHS-OIG's Perspective on Managed Care

03-19-2024

• Utah MMIS and E&E System Had Adequate Security Controls In Place, but Improvements Are Needed A-18-21-09001
• South Carolina MMIS and E&E System Security Controls Were Adequate, but Some Improvements Are Needed A-18-22-09005

03-18-2024

• NEW HHS-OIG Impact Brief: Medicare Advantage Prior Authorization

03-15-2024

• Updated: Work Plan

03-14-2024

• Medicaid Fraud Control Units Fiscal Year 2023 Annual Report

03-13-2024

• Kansas's Medicaid Estate Recovery Program Was Cost Effective, but Kansas Did Not Always Follow Its Procedures, Which Could Have Resulted in Reduced Recoveries A-07-22-03254
• Pennsylvania Improperly Claimed $551 Million in Medicaid Funds for Its School-Based Program A-02-21-01011
• IG Grimm Named Among Top Women Leaders in Health Care

03-12-2024

• Issue Brief: Insights from OIG's Work on the Office of Refugee Resettlement's Efforts to Care for Unaccompanied Children OEI-09-23-00440

03-11-2024

• FY 2025 Congressional Budget Justification
• Updated: CMP and Affirmative Exclusions

03-08-2024

• LEIE Database Updated with February 2024 Exclusions and Reinstatements

03-07-2024

• Updated: Fraud Self-Disclosures
• HRSA Made Some Potential Overpayments to Providers Under the Phase 2 General Distribution of the Provider Relief Fund Program A-09-22-06001

03-06-2024

• Consumer Alert: Urinary Catheter Scams
• Data Snapshot: Biosimilar Cost and Use Trends in Medicare Part B OEI-05-22-00141

February 2024

02-29-2024

• Lessons Learned During the Pandemic Can Help Improve Care in Nursing Homes OEI-02-20-00492

02-26-2024

• Advisory Opinion 24-01 Favorable opinion regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would

02-22-2024

• New: Single Audits - Information and Oversight Activities

02-20-2024

• Findings of Whistleblower Retaliation by Indian Health Service Contractor Management
• Updated: Connecticut State False Claims Act Review Letter
• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That MediGold (Contract H3668) Submitted to CMS A-07-20-01198

02-16-2024

• Report to Congress on the Reported Impact of Discarded-Drug Refunds on Biosimilar Biological Products A-06-23-04003

02-15-2024

• Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2023 OEI-03-24-00050
• Updated: Work Plan
• Gaps in Sponsor Screening and Followup Raise Safety Concerns for Unaccompanied Children OEI-07-21-00250

02-14-2024

• Medicare Generally Paid for Evaluation and Management Services Provided via Telehealth During the First 9 Months of the COVID-19 Public Health Emergency That Met Medicare Requirements A-01-21-00501
• Updated: Corporate Integrity Agreements

02-08-2024

• NIH Generally Implemented System Controls Over the Sequence Read Archive But Some Improvements Needed A-18-22-03300
• LEIE Database Updated with January 2024 Exclusions and Reinstatements
• Updated: Fraud Self-Disclosures

02-06-2024

• Colorado Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-07-22-07009
• Job Opening: ACRB Deputy Branch Chief

02-02-2024

• Updated: Corporate Integrity Agreements

January 2024

01-29-2024

• Updated: CMP and Affirmative Exclusions

01-26-2024

• Updated: Fraud Risk Indicator

01-22-2024

• Updated: CMP and Affirmative Exclusions

01-19-2024

• HHS-OIG Issues Notice of Exclusion to Founder and CEO of Theranos, Inc.

01-18-2024

• Updated: Corporate Integrity Agreements

01-16-2024

• Two Tribes in Oklahoma and Their Health Programs Did Not Meet All Federal and Tribal Requirements for Background Investigations on Individuals in Contact With Indian Children A-01-20-01505
• Updated: Work Plan

01-12-2024

• CDC Has Improved the Nursing Homes Reporting Process for COVID-19 Data in NHSN, but Challenges Remain OEI-06-22-00030
• Updated: Corporate Integrity Agreements
• Updated: Fraud Self-Disclosures
• Updated: Grant and Contractor Fraud Self-Disclosures

01-11-2024

• Independent Attestation Review: Substance Abuse and Mental Health Services Administration Fiscal Year 2023 Detailed Accounting Report and Budget Formulation Compliance Report for National Drug Control
• Independent Attestation Review: Indian Health Service Fiscal Year 2023 Detailed Accounting Report and Budget Formulation Compliance Report for National Drug Control Activities, and Accompanying Requir
• 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

01-10-2024

• LEIE Database Updated with December 2023 Exclusions and Reinstatements
• Job Opening: ACRB Deputy Branch Chief

01-09-2024

• Oklahoma Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-06-22-09007
• Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-23-00637
• Cahaba Safeguard Administrators, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2020 A-07-23-00631
• Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-23-00635
• Cahaba Government Benefits Administrators, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-23-00634
• Cahaba Government Benefits Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-23-00636

01-05-2024

• Cahaba Government Benefits Administrators, LLC, Properly Updated the Medicare Segment Pension Assets and Overstated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of December 3

01-03-2024

• Advisory Opinion 23-12 Favorable opinion regarding a one-time, voluntary redemption offer to physician partners reaching age 67 to have their partnership units repurchased by a partnership over a 2-ye
• Advisory Opinion 23-13 Favorable opinion regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would
• Advisory Opinion 23-14 Favorable opinion regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would
• Advisory Opinion 23-15 Favorable opinion regarding a physician consulting company's proposal to offer physician practices that are current customers of the company certain gift cards for referring pot
• Fraud Self-Disclosures
• CMP and Affirmative Exclusions
• Grant Fraud Self-Disclosures
• CIA Reportable Events
• Civil Monetary Penalties and Affirmative Exclusions
• Press Release
• Fact Sheet: Final Rule: Revisions to the Safe Harbors Under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements
• Press Release: OIG proposes rule for civil money penalties for information blocking
• Joint Statement: Statements from the Office of the National Coordinator for Health IT and the Centers for Medicare & Medicaid Services on Interoperability Flexibilities amid the COVID-19 Public Health
• Telehealth Factsheet
• Telehealth Frequently Asked Questions
• Fact Sheet: Notice of Proposed Rulemaking OIG-0936-AA10-P
• Interactive Map
• Data Chart