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What's New

See also: Archive

December

12-01-2023
Fall 2023 Semiannual Report to Congress
HHS-OIG's Efforts Result in $3.44 Billion in Expected Recoveries, According to Latest Report

November

11-30-2023
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That SelectCare of Texas, Inc. (Contract H4506), Submitted to CMS A-06-19-05002
11-28-2023
Multiple States Made Medicaid Capitation Payments to Managed Care Organizations After Enrollees' Deaths A-04-21-09005
Early Alert: Part B Payment Amount for Tezspire Included a Noncovered Self-Administered Version in 2023 OEI-BL-24-00030
11-27-2023
The Risk of Misuse and Diversion of Buprenorphine for Opioid Use Disorder in Medicare Part D Continues to Appear Low: 2022 OEI-02-24-00130
11-22-2023
Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2022 A-18-23-11300
11-21-2023
Consumer Alert: Remote Patient Monitoring
11-20-2023
Some of California's Substance Abuse Prevention and Treatment Block Grant Expenditures for Los Angeles County Did Not Comply With Federal and State Requirements A-09-21-01001
Updated: Corporate Integrity Agreements
11-17-2023
Kentucky Experienced Challenges in Meeting Federal and State Foster Care Program Requirements During the COVID-19 Pandemic A-06-22-07001
11-16-2023
2023 Top Management & Performance Challenges Facing HHS
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2023 OEI-03-24-00040
11-15-2023
Updated: Work Plan
11-14-2023
FY 2022 Health Care Fraud and Abuse Control Program Report
11-13-2023
The Food and Drug Administration Needs To Improve the Premarket Tobacco Application Review Process for Electronic Nicotine Delivery Systems To Protect Public Health A-06-22-01002
Pennsylvania Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-03-22-00206
11-09-2023
LEIE Database Updated with October 2023 Exclusions and Reinstatements
CMS Can Do More To Leverage Medicare Claims Data To Identify Unreported Incidents of Potential Abuse or Neglect A-01-22-00501
11-07-2023
Updated: Corporate Integrity Agreements
Updated: Fraud Self-Disclosures
Updated: CMP and Affirmative Exclusions
11-06-2023
NEW: General Compliance Program Guidance
Congressional Mandate: Part B Payment Amounts for Two Drugs Included Noncovered Self Administered Versions in 2022 OEI-BL-22-00380
11-03-2023
Noridian Healthcare Solutions Reopened and Corrected Cost Report Final Settlements To Collect $11 Million in Net Overpayments That Had Been Made to Medicare Providers A-06-22-05000
11-01-2023
HHS's Oversight of Automatic Provider Relief Fund Payments Was Generally Effective but Improvements Could Be Made A-02-20-01025

October

10-30-2023
New York City Department of Health and Mental Hygiene Charged Some Unallowable Costs to Its CDC COVID-19 Award A-04-22-02035
Medicare Advantage Compliance Audit of Diagnosis Codes That CarePlus Health Plans, Inc. (Contract H1019) Submitted to CMS A-04-19-07082
10-27-2023
CDC's Internal Control Weaknesses Led to Its Initial COVID-19 Test Kit Failure, but CDC Ultimately Created a Working Test Kit A-04-20-02027
10-25-2023
Advisory Opinion 23-08 Unfavorable opinion regarding a cochlear implant manufacturer’s proposal to offer and provide a free compatible hearing aid to certain patients, including Federal health care program beneficiaries, who receive one of the cochlear implants it manufactures.
10-24-2023
States Face Ongoing Challenges in Meeting Third-Party Liability Requirements for Ensuring That Medicaid Functions as the Payer of Last Resort A-05-21-00013
10-23-2023
Updated: Fraud Risk Indicator
Updated: CMP and Affirmative Exclusions
10-20-2023
South Dakota MMIS and E&E System Security Controls Were Partially Effective and Improvements Are Needed A-18-21-09004
10-19-2023
Mississippi Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-21-06103
10-18-2023
The Strategic National Stockpile Was Not Positioned To Respond Effectively to the COVID-19 Pandemic A-04-20-02028
10-16-2023
Updated: Work Plan
10-13-2023
Advisory Opinion 23-07 Favorable opinion regarding an employer’s proposal to pay bonuses to its employed physicians based on net profits derived from certain procedures performed by the physicians.
Updated: Annual Inflation Updates to the Annual Cap on Patient Engagement Tools and Supports Under 42 CFR § 1001.952(hh)
10-11-2023
Medicare Could Save Millions if It Implements an Expanded Hospital Transfer Payment Policy for Discharges to Postacute Care A-01-21-00504
10-10-2023
LEIE Database Updated with September 2023 Exclusions and Reinstatements
10-06-2023
Illinois State University's Management of NIH Awards Complied With Federal and Financial Conflict of Interest Requirements A-05-20-00033
Updated: Corporate Integrity Agreements
Updated: Fraud Self-Disclosures
10-05-2023
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Aetna, Inc. (Contract H5521) Submitted to CMS A-01-18-00504
10-03-2023
New Jersey Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-02-22-01004
Updated: Corporate Integrity Agreements

September

09-29-2023
Many Medicaid Enrollees with Opioid Use Disorder Were Treated with Medication; However, Disparities Present Concerns OEI-BL-22-00260
District of Columbia Medicaid Fraud Control Unit: 2022 Onsite Review OEI-06-22-00420
09-28-2023
Advisory Opinion 23-06 Unfavorable opinion regarding a laboratory company’s proposal to purchase anatomic pathology services from third-party laboratories.
09-27-2023
Texas Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State A-05-22-00018
Home Health Agencies Rarely Furnished Services Via Telehealth Early in the COVID-19 Public Health Emergency A-05-21-00026
CDC Provided Oversight and Assistance; However, ELC Recipients Still Faced Challenges in Implementing COVID-19 Screening Testing Programs A-05-22-00010
09-26-2023
Four States Reviewed Received Increased Medicaid COVID-19 Funding Even Though They Terminated Some Enrollees' Coverage for Unallowable or Potentially Unallowable Reasons A-06-21-09002
HRSA Had An Effective Process To Identify And Monitor High-Risk Health Centers That Received COVID-19 Grant Funds A-01-21-01503
Medicare Advantage Compliance Audit of Diagnosis Codes That Health Net of California, Inc. (Contract H0562) Submitted to CMS A-09-18-03007
09-25-2023
Alabama Did Not Always Invoice Rebates to Manufacturers for Pharmacy and Physician-Administered Drugs A-04-21-08090
09-22-2023
Employee Profile: Patrick Neubert
09-21-2023
FDA Could Take Stronger Enforcement Action Against Tobacco Retailers With Histories of Sales to Youth and Other Violations OEI-01-20-00240
Supplemental Data on Tobacco Retailer Inspections OEI-01-20-00242
Review of Personnel Shortages in Federal Health Care Programs During the COVID-19 Pandemic
09-20-2023
New York Did Not Ensure That a Managed Care Organization Complied With Requirements for Denying Prior Authorization Requests A-02-21-01016
Key Strategies That States Used for Managing Medicaid and Marketplace Enrollment During the COVID-19 PHE 
09-19-2023
Updated:
09-18-2023
2024 Spring Health Care Fraud And Abuse Legal Internship
09-15-2023
Updated: Work Plan
Amerigroup Iowa's Prior Authorization and Appeal Processes Were Effective, but Improvements Can Be Made A-07-22-07007
09-14-2023
Kentucky Did Not Always Invoice Manufacturers for Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-04-22-07102
Novitas Solutions, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals A-07-23-00633
09-13-2023
Puerto Rico Claimed Over $7 Million in Federal Reimbursement for Medicaid Capitation Payments Made on Behalf of Enrollees Who Were or May Have Been Deceased A-02-21-01005
Puerto Rico Claimed More Than $500 Thousand in Unallowable Medicaid Managed Care Payments for Enrollees Assigned More Than One Identification Number A-02-21-01004
The Substance Abuse and Mental Health Services Administration Did Not Ensure That Clinics Fully Complied With Federal Requirements When Awarding and Monitoring Certified Community Behavioral Health Clinic Expansion Grants A-02-21-02010
09-12-2023
Risk Assessment of the Administration for Children and Families' Purchase Card Program for Fiscal Year 2021 A-04-22-06262
CDC's Vaccines for Children Program Recipients Did Not Conduct Site Visits at Some Providers as Required A-09-22-01000
Medicare Improperly Paid Acute-Care Hospitals for Inpatient Claims Subject to the Post-Acute-Care Transfer Policy Over a 4-Year Period, but CMS's System Edits Were Effective in Reducing Improper Payments by the End of the Period A-09-23-03016
09-11-2023
Updated: Corporate Integrity Agreements
09-08-2023
Georgia Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-04-22-08093
Minnesota Medicaid Fraud Control Unit: 2022 Inspection OEI-06-22-00430
09-07-2023
Home Health Agencies Failed To Report Over Half of Falls With Major Injury and Hospitalization Among Their Medicare Patients OEI-05-22-00290
LEIE Database Updated with August 2023 Exclusions and Reinstatements
09-06-2023
Nursing Homes Reported Wide-Ranging Challenges Preparing for Public Health Emergencies and Natural Disasters OEI-06-22-00100
09-05-2023
Florida Did Not Refund $106 Million Federal Share of Medicaid Managed Care Rebates It Received for Calendar Years 2015 Through 2020 A-04-22-04089
Risk Assessment of the Administration for Children and Families' Travel Card Program for Fiscal Year 2021 A-04-22-06263
Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria Inspectors General Coordinated PEPFAR Oversight Plan Fiscal Year 2024 U.S. Department of Health and Human Services, Office of Inspector General A-04-23-01027
09-01-2023
Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2021 Average Sales Prices OEI-03-23-00120
Updated: Corporate Integrity Agreements

August

08-31-2023
One Quarter of Medicaid Enrollees with HIV May Not Have Received Critical Services in 2021 OEI-05-22-00240
Widespread Pandemic Disruption Spurred Innovation to State Paternity Establishment Practices OEI-06-21-00150
08-28-2023
Featured Topic: Managed Care
08-18-2023
Advisory Opinion 23-05 Unfavorable opinion regarding a company’s proposal to assist physicians who perform surgeries for which the company’s services are used with the formation and operation of a turnkey physician-owned entity that would perform those same services.
Medicare Made $17.8 Million in Potentially Improper Payments for Opioid-Use-Disorder Treatment Services Furnished by Opioid Treatment Programs A-09-22-03005
08-16-2023
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2023 OEI-03-23-00100
08-15-2023
Updated: Work Plan
Texas Inappropriately Claimed Nearly $1.8 Million in Federal Medicaid Funds for Private Medicaid Management Information System Contractor Costs A-06-19-09003
08-14-2023
Updated: Corporate Integrity Agreements
08-11-2023
Medicare Paid Independent Organ Procurement Organizations Over Half a Million Dollars for Professional and Public Education Overhead Costs That Did Not Meet Medicare Requirements A-09-21-03020
Office of Inspector General's Partnership With the Commonwealth of Massachusetts Office of the State Auditor: Office of Medicaid (MassHealth)-Review of Capitation Payments A-01-22-00002
08-10-2023
LEIE Database Updated with July 2023 Exclusions and Reinstatements
States With Separate Children's Health Insurance Programs Could Have Collected an Estimated $641 Million Annually If States Were Required To Obtain Rebates Through the Medicaid Drug Rebate Program A-07-22-06106
08-04-2023
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Presbyterian Health Plan, Inc. (Contract H3204) Submitted to CMS A-07-20-01197
First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs A-07-23-00630
First Coast Service Options, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals A-07-23-00632
First Coast Service Options, Inc., Overstated Its Medicare Segment Postretirement Benefit Assets as of January 1, 2019 A-07-23-00629
Updated:
08-03-2023
Employee Profile: Demetrius Martinez
First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Supplemental Executive Retirement Plan Costs A-07-22-00626
Updated: Corporate Integrity Agreements
08-02-2023
Findings of Whistleblower Retaliation Health Resources and Services Administration Grantee Management Official
Telehealth During 2020 Helped Ensure End-Stage Renal Disease Patients Received Care, But Limited Information Related to Telehealth Was Documented A-05-22-00015
New York Improved Its Monitoring of Medicaid Community Rehabilitation Services But Still Claimed Improper Federal Medicaid Reimbursement Totaling $20 Million A-02-22-01011
Medicare Paid $30 Million for Accumulated Repair Costs That Exceeded the Federally Recommended Cost Limit for Wheelchairs During Their 5-Year Reasonable Useful Lifetime A-09-22-03003

July

07-24-2023
Virginia Made Capitation Payments to Medicaid Managed Care Organizations After Enrollees' Deaths A-03-22-00203
07-21-2023
Although IHS Allocated COVID-19 Testing Funds To Meet Community Needs, It Did Not Ensure That the Funds Were Always Used in Accordance With Federal Requirements A-07-20-04123
Updated: CMP and Affirmative Exclusions
07-20-2023
Updated: Corporate Integrity Agreements
07-19-2023
High Rates of Prior Authorization Denials by Some Plans and Limited State Oversight Raise Concerns About Access to Care in Medicaid Managed Care OEI-09-19-00350
Florida Did Not Comply With Requirements for Documenting Psychotropic and Opioid Medications Prescribed for Children in Foster Care A-05-22-00009
07-18-2023
HRSA Made COVID-19 Uninsured Program Payments to Providers on Behalf of Individuals Who Had Health Insurance Coverage and for Services Unrelated to COVID-19 A-02-21-01013
Updated: Fraud Risk Indicator
07-17-2023
Updated: Work Plan
Targeted Provider Relief Funds Allocated to Hospitals Had Some Differences with Respect to the Ethnicity and Race of Populations Served OEI-05-20-00580
07-12-2023
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Excellus Health Plan, Inc. (Contract H3351) Submitted to CMS A-07-20-01202
07-11-2023
Advisory Opinion 23-04 (Favorable) Regarding: (i) the use of a health technology company’s online health care directory by Federal health care program beneficiaries to search for and book medical appointments with providers and the display of sponsored advertisements to Federal health care program beneficiaries on the directory and certain third-party websites; and (ii) certain proposed changes to the functionality of the directory.
Updated:
07-10-2023
LEIE Database Updated with June 2023 Exclusions and Reinstatements
Updated Interactive Maps: Office of Audit Services Opioid Reviews
07-07-2023
Updated: Corporate Integrity Agreements
07-06-2023
Adverse Events Toolkits: Medical Review Methodology and Clinical Guidance for Identifying Patient Harm
Part D Plans Generally Include Drugs Commonly Used by Dual-Eligible Enrollees: 2023 OEI-05-23-00130
Tracking Pandemic Relief Funds that Went to Local Communities Reveals Persistent Data Gaps and Data Reliability Issues
07-05-2023
Updated: Information Blocking Final Rule

June

06-29-2023
Noridian Healthcare Solutions, LLC, Made $8.8 Million in Improper Monthly Capitation Payments to Physicians and Qualified Nonphysician Practitioners in Jurisdiction E for Certain Services Related to End-Stage Renal Disease A-09-21-03016
06-28-2023
2023 Nationwide Health Care Fraud Enforcement Action
A Resource Guide for Using Medicare's Enrollment Race and Ethnicity Data OEI-02-21-00101
06-27-2023
Information Blocking Final Rule
06-23-2023
CMS's Oversight of Medicare Payments for the Highest Paid Molecular Pathology Genetic Test Was Not Adequate To Reduce the Risk of up to $888 Million in Improper Payments A-09-22-03010
Updated: Corporate Integrity Agreements
Updated: Civil Monetary Penalties and Affirmative Exclusions
06-21-2023
2022 Performance Data for the Senior Medicare Patrol Projects OEI-02-23-00150
06-20-2023
Updated: Corporate Integrity Agreements
06-15-2023
Updated: Work Plan
Updated: Corporate Integrity Agreements
06-13-2023
Alaska Experienced Challenges in Meeting Federal and State Foster Care Program Requirements During the COVID-19 Pandemic A-06-21-07006
06-08-2023
LEIE Database Updated with May 2023 Exclusions and Reinstatements
06-07-2023
Employee Profile: Lauren Buss
Updated: Corporate Integrity Agreements
06-06-2023
NIH Should Improve Its Management of Contracts for the Acquisition of Information Technology A-18-21-11500
Updated:
06-02-2023
Spring 2023 Semiannual Report to Congress
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Keystone Health Plan East, Inc. (Contract H3952) Submitted to CMS A-03-20-00001
Saint Louis University's Management of NIH Grant Awards Did Not Comply With All Federal Requirements but Complied With Financial Conflict of Interest Requirements A-07-20-05127

May

05-31-2023
Medicare Paid Millions More for Physician Services at Higher Nonfacility Rates Rather Than at Lower Facility Rates While Enrollees Were Inpatients of Facilities A-04-21-04084
Vermont Complied With Regulations When Implementing Programs Under SAMHSA's Opioid Response Grants, but Claimed Unallowable Expenditures  A-01-20-01501
Florida Did Not Ensure That Some Providers Complied With Requirements For Determining Eligibility For Its Projects for Assistance in Transition From Homelessness Program A-02-21-02008
Updated: General Questions Regarding Certain Fraud and Abuse Authorities
05-30-2023
Maryland MMIS and E&E System Security Controls Were Partially Effective and Improvements Are Needed A-18-21-09003
05-25-2023
The Office of Refugee Resettlement Needs To Improve Its Oversight Related to the Placement and Transfer of Unaccompanied Children A-06-20-07002
The Centers for Medicare & Medicaid Services Should Improve Preventative and Detective Controls To More Effectively Mitigate the Risk of Compromise A-18-20-08001
05-24-2023
Video: Assistant IG for Evaluation and Inspections Erin Bliss Testifies Before the Committee on Aging: "Residents at Risk: The Strained Nursing Home Inspection System and the Need to Improve Oversight, Transparency, and Accountability"
05-23-2023
Video: Testimony of Megan Tinker, Chief of Staff, before the U.S. Senate Homeland Security & Governmental Affairs Committee: "Examining Health Care Denials and Delays in Medicare Advantage"
Seventeen of Thirty Selected Health Centers Did Not Use or May Not Have Used Their HRSA COVID-19 Supplemental Grant Funding in Accordance With Federal Requirements A-02-21-02005
05-22-2023
Employee Profile: Rochelle Wong
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 Year 2022 A-17-23-52000
05-19-2023
Montana Generally Complied With Requirements for Telehealth Services During the COVID-19 Pandemic A-07-21-03250
05-18-2023
Testimony of Erin Bliss, Assistant Inspector General for Evaluation and Inspections, before the U.S. Senate Special Committeeon Aging: "Residents at Risk: The Strained Nursing Home Inspection System and the Need to Improve Oversight, Transparency, and Accountability"
The Risk of Misuse and Diversion of Buprenorphine for Opioid Use Disorder Appears to Be Low in Medicare Part D OEI-02-22-00160
Massachusetts MMIS and E&E System Security Controls Were Generally Effective, but Some Improvements Are Needed A-18-20-08003
05-17-2023
Testimony of Megan Tinker, Chief of Staff, before the U.S. Senate Homeland Security & Governmental Affairs Committee: "Examining Health Care Denials and Delays in Medicare Advantage"
05-16-2023
Consumer Alert: Fraud Schemes Targeting Native American Communities in Behavioral Health Treatment Centers
05-15-2023
Updated: Work Plan
State Agencies Can Improve Their Reporting of Children Missing From Foster Care to Law Enforcement for Entry Into the National Crime Information Center Database as Required by Federal Statute A-07-21-06104
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2022 OEI-03-23-00090
05-12-2023
Updated: CMP and Affirmative Exclusions
05-10-2023
Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2022 A-18-22-11200
LEIE Database Updated with April 2023 Exclusions and Reinstatements
05-09-2023
Updated:
05-04-2023
Medicare Improperly Paid Providers for Some Psychotherapy Services, Including Those Provided via Telehealth, During the First Year of the COVID-19 Public Health Emergency A-09-21-03021
The Office of Refugee Resettlement Needs To Improve Its Practices for Background Checks During Influxes A-06-21-07003
Updated: Corporate Integrity Agreements
05-02-2023
Inspector General Grimm HCCA 27th Annual Compliance Institute Keynote

April

04-26-2023
Medicare Could Have Saved Up To $128 Million Over 5 Years if CMS Had Implemented Controls To Address Duplicate Payments for Services Provided to Individuals With Medicare and Veterans Health Administration Benefits A-09-22-03004
04-24-2023
Toolkit: Analyzing Telehealth Claims to Assess Program Integrity Risks OEI-02-20-00723
Crow/Northern Cheyenne Hospital—an IHS-Operated Health Facility—Did Not Timely Conduct Required Background Checks of Staff and Supervise Certain Staff A-02-21-02004
Compliance Guidance Update
Modification of 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 and then forgive that debt.)
04-21-2023
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HumanaChoice (Contract H6609) Submitted to CMS A-05-19-00013
04-20-2023
2023 Nationwide COVID-19 Health Care Fraud Enforcement Action
04-19-2023
Updated: CMP and Affirmative Exclusions
04-18-2023
Testimony of Christi A. Grimm, Inspector General, United States House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, Testimony to "Insights from the HHS Inspector General on Oversight of Unaccompanied Minors, Grant Management, and CMS"
04-17-2023
Updated: Work Plan
04-14-2023
Updated: Fraud Risk Indicator
04-12-2023
CMS Did Not Accurately Report on Care Compare One or More Deficiencies Related to Health, Fire Safety, and Emergency Preparedness for an Estimated Two-Thirds of Nursing Homes A-09-20-02007
04-10-2023
LEIE Database Updated with March 2023 Exclusions and Reinstatements
04-07-2023
Updated: Corporate Integrity Agreements
04-06-2023
Updated:
04-04-2023
Employee Profile: Curtis Roy
04-03-2023
Rhode Island Medicaid Fraud Control Unit: 2022 Inspection OEI-07-22-00370

March

03-31-2023
Texas Could Not Support the Permissibility of the Funds Used as the State Share of the Medicaid Delivery System Reform Incentive Payment Program A-06-17-09004
03-30-2023
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cigna-HealthSpring Life & Health Insurance Company, Inc. (Contract H4513) Submitted to CMS A-07-19-01192
03-29-2023
Advisory Opinion 23-03 (Regarding a proposal to provide a prepaid card to certain individuals, including Federal health care program beneficiaries, to encourage those individuals to return the sample collection kit associated with a colorectal cancer screening test.)
Missouri's Oversight of Certified Individualized Supported Living Provider Health and Safety Could Be Improved in Some Areas A-07-21-03247
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That MCS Advantage, Inc. (Contract H5577) Submitted to CMS A-02-20-01008
03-28-2023
Featured Topic: Hospice
03-27-2023
Maryland's Child Support Administration Generally Claimed Administrative Costs That Were Allowable and Allocable A-01-22-02500
03-24-2023
Medicare Improperly Paid Physicians an Estimated $30 Million for Spinal Facet-Joint Interventions A-09-22-03006
03-21-2023
The District of Columbia Has Taken Significant Steps To Ensure Accountability Over Amounts Managed Care Organizations Paid to Pharmacy Benefit Managers A-03-20-00200
03-20-2023
Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Geisinger Health Plan (Contract H3954) Submitted to CMS A-09-21-03011
03-17-2023
Georgia Did Not Comply With Federal Waiver and State Requirements at All 20 Adult Day Health Care Facilities Reviewed A-04-22-00134
03-15-2023
IG Grimm RISE Conference Speech - OIG’s Vantage on Medicare Advantage
Updated: Work Plan
Georgia Did Not Always Invoice Rebates to Manufacturers for Pharmacy and Physician-Administered Drugs A-04-21-08089
03-14-2023
Some Skin Substitute Manufacturers Did Not Comply with New ASP Reporting Requirements OEI-BL-23-00010
03-13-2023
FY 2024 Congressional Budget Justification
Medicare Improperly Paid Physicians for Epidural Steroid Injection Sessions A-07-21-00618
Michigan MMIS and E&E Systems Security Controls Were Generally Effective, but Some Improvements Are Needed A-18-20-08004
03-10-2023
OIG’s COVID-19 Public Health Emergency Flexibilities End on May 11, 2023 Upon Expiration of the COVID-19 Public Health Emergency Declaration
Medicaid Fraud Control Units Fiscal Year 2022 Annual Report  OEI-09-23-00190
LEIE Database Updated with February 2023 Exclusions and Reinstatements
03-08-2023
Findings of Whistleblower Retaliation by Army and Contractor Jacobs Technologies Management Officials
Updated:
03-07-2023
Florida Did Not Invoice Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-04-21-07098
03-06-2023
Women's History Month: The Legacy of IG June Gibbs-Brown
03-03-2023
State Agencies Did Not Always Ensure That Children Missing From Foster Care Were Reported to the National Center for Missing and Exploited Children in Accordance With Federal Requirements A-07-21-06102
Updated: Corporate Integrity Agreements
03-02-02023
The Inability To Identify Denied Claims in Medicare Advantage Hinders Fraud Oversight OEI-03-21-00380
Medicare Part D Plan Sponsors and CMS Did Not Ensure That Transmucosal Immediate-Release Fentanyl Drugs Were Dispensed Only to Beneficiaries Who Had a Cancer Diagnosis A-09-20-03033
03-01-2023
Medicare Could Have Saved up to $216 Million Over 5 Years if Program Safeguards Had Prevented At-Risk Payments for Definitive Drug Testing Services A-09-21-03006

February

02-28-2023
Updated List: High Risk - Heightened Scrutiny
Advisory Opinion 23-02 (Regarding a program to provide a drug for free, for a limited time, to patients who experience a delay in their insurance approval process for the drug.)
02-27-2023
Missouri Claimed Federal Medicaid Reimbursement for Tens of Millions in Consumer-Directed Personal Care Assistance Services That Did Not Comply With Federal and State Requirements A-07-20-03243
02-24-2023
Fraud Alert: Scammers Steal Money From the Public Through Fake HHS Websites and Social Media Schemes
Florida Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State A-05-21-00028
02-23-2023
The Health Resources and Services Administration Should Improve Preventive and Detective Controls To More Effectively Mitigate the Risk of Compromise A-18-20-08200
Advisory Opinion 23-01 (Regarding financial assistance for transportation, lodging, and meals provided by a drug manufacturer to financially needy pediatric patients and their caregiver(s) in connection with treatment with the manufacturer’s drug.)
02-17-2023
Employee Profile: Jasmyn Ferbish
02-15-2023
Updated: Work Plan
02-14-2023
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2022 OEI-03-23-00080
Updated: Fraud Self-Disclosures
02-13-2023
Michigan Did Not Comply With Requirements for Documenting Psychotropic and Opioid Medications Prescribed for Children in Foster Care A-05-21-00030
Updated: Civil Monetary Penalties and Affirmative Exclusions
02-10-2023
LEIE Database Updated with January 2023 Exclusions and Reinstatements
02-08-2023
North Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-21-07002
Updated: Corporate Integrity Agreements
02-07-2023
Technical Assistance Brief: Implementation of Inflation-Indexed Rebates for Part B Drugs OEI-BL-23-00170

January

01-31-2023
Early Challenges Highlight Areas for Improvement in COVID-19 Vaccination Programs OEI-04-21-00190
Challenges With Vaccination Data Hinder State and Local Immunization Program Efforts To Combat COVID-19 OEI-05-22-00010
Updated: Fraud Risk Indicator
01-27-2023
Greater Bergen Community Action, Inc., Did Not Manage Its Head Start Awards in Accordance With Federal and State Requirements A-02-19-02008
01-25-2023
Operation Nightingale Enforcement Action
The National Institutes of Health and EcoHealth Alliance Did Not Effectively Monitor Awards and Subawards, Resulting in Missed Opportunities to Oversee Research and Other Deficiencies A-05-21-00025
01-20-2023
Employee Profile: Abbi Warmker
Updated: Corporate Integrity Agreements
Independent Attestation Review: National Institutes of Health Fiscal Year 2022 Detailed Accounting Submission and Budget Formulation Compliance Report for National Drug Control Activities, and Accompanying Required Assertions A-03-23-00351
Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2022 Detailed Accounting Submission and Budget Formulation Compliance Report for National Drug Control Activities and Accompanying Required Assertions A-03-23-00352
Independent Attestation Review: Food and Drug Administration Fiscal Year 2022 Detailed Accounting Submission and Budget Formulation Compliance Report for National Drug Control Activities and Accompanying Required Assertions A-03-23-00353
01-19-2023
More Than a Thousand Nursing Homes Reached Infection Rates of 75 Percent or More in the First Year of the COVID-19 Pandemic; Better Protections Are Needed for Future Emergencies OEI-02-20-00491
01-18-2023
ASPR Could Improve Its Oversight of the Hospital Preparedness Program To Ensure That Crisis Standards of Care Comply With Federal Nondiscrimination Laws A-01-21-01502
01-17-2023
Updated: Work Plan
Updated List: High Risk - Heightened Scrutiny
FDA Should Improve Its Management of Contracts for the Acquisition of Information Technology A-18-21-11100
01-13-2023
New Interactive: Recommendations Tracker
01-12-2023
Updated: Fraud Self-Disclosures
01-10-2023
LEIE Database Updated with December 2022 Exclusions and Reinstatements
Updated: Corporate Integrity Agreements
01-09-2023
WANTED: Fugitive Khalid A. Satary
National Government Services, Inc., Understated Its Plan A Medicare Segment Pension Assets and Overstated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of December 31, 2018 A-07-22-00620
National Government Services, Inc., Overstated Its Plan B Medicare Segment Pension Assets and Overstated Medicare's Share of the Medicare Segment Excess Pension Assets as of December 31, 2018 A-07-22-00621
National Government Services, Inc., Overstated Its United Government Services, LLC, Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of December 31, 2018 A-07-22-00622
National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-22-00623
01-06-2023
Illinois Generally Complied With Requirements for Claiming Medicaid Reimbursement for Telehealth Payments During COVID-19 A-05-21-00035
The Municipality of Manati Did Not Always Manage Its Head Start Disaster Assistance Awards in Accordance With Federal And Commonwealth Requirements A-04-20-02032
Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings A-04-22-06265
01-05-2023
Updated: Corporate Integrity Agreements
01-04-2023
Updated: Corporate Integrity Agreements
01-03-2023
Manufacturers May Need Additional Guidance To Ensure Consistent Average Sales Price Calculations OEI-BL-21-00330
CMS Should Bolster Its Oversight of Manufacturer-Submitted Average Sales Price Data To Ensure Accurate Part B Drug Payments OEI-03-21-00390

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