What's New

December 2025

12-23-2025

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

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

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

12-17-2025

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

12-16-2025

• Oklahoma Medicaid Fraud Control Unit: 2025 Inspection OEI-07-25-00060
• 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

12-15-2025

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

12-12-2025

• Updated: Corporate Integrity Agreements
• 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 Co

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

12-08-2025

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

12-05-2025

• Podiatrists’ Claims for Evaluation and Management Services Did Not Comply With Medicare Requirements A-09-22-03012
• 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
• 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
• Video: Combating Durable Medical Equipment Fraud

11-24-2025

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

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

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

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
• 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
• 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

11-12-2025

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

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-

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

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

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

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

10-23-2025

• Updated: CMP and Affirmative Exclusions

10-15-2025

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

10-10-2025

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

10-07-2025

• Vermont Medicaid Fraud Control Unit: 2024 Inspection OEI-07-24-00340Updated: Corporate Integrity Agreements
• 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

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

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

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

• Puerto Rico Medicaid Fraud Control Unit: 2024 Onsite Review OEI-06-24-00300
• 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 f

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-

09-05-2025

• 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-02-23-00261 Most Health Centers Provide Some Behavioral Health Services to Patients With Substance Use Disorder, Despite Facing Challenges That Li

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-25-07-049 Comparison of Average Sales Prices and Ave

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 Provid
• 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 Co

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

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 t
• 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 ce

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 ass

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 reques
• 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 Contr
• 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 telehe
• 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 Actions Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Ap

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-Rel
• 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 t

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 Identificat

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 t

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 Con
• 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
• 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 adequa
• 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-

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