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What's New

June

06-17-2019
Princeton Place Did Not Always Comply With Care Plans for Residents Who Were Diagnosed With Urinary Tract Infections (A-06-17-02002)
The Therapy Resource Utilization Groups at Epworth Villa Retirement Community's Skilled Nursing Facility Were Properly Supported (A-06-18-08002)
06-14-2019
The National Institutes of Health Could Improve Its Monitoring To Ensure That an Awardee of the All of Us Research Program Had Adequate Cybersecurity Controls To Protect Participants' Sensitive Data Audit (A-18-17-09304)
Updated Corporate Integrity Agreement List
Job Opening: Medicare/Medicaid Attorney Deadline to Apply: June 28, 2019
06-13-2019
Alaska Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities (A-09-17-02006)
06-12-2019
Video: Eye on Oversight: Abuse & Neglect of Medicare Beneficiaries
Media Materials: Abuse and Neglect of Medicare Beneficiaries
CMS Could Use Medicare Data To Identify Instances of Potential Abuse or Neglect (A-01-17-00513)
Incidents of Potential Abuse and Neglect at Skilled Nursing Facilities Were Not Always Reported and Investigated (A-01-16-00509)
Medicare Payments to Providers for Polysomnography Services Did Not Always Meet Medicare Billing Requirements (A-04-17-07069)
Most Hospitals Obtain Compounded Drugs From Outsourcing Facilities, Which Must Meet FDA Quality Standards (OEI-01-17-00090)
06-11-2019
New York May Not Have Complied With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-02-16-01022)
The University of Kentucky Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program (A-04-18-02012)
Updated Provider Self-Disclosure Settlements
06-07-2019
Nevada Medicaid Fraud Control Unit: 2018 Onsite Inspection (OEI-06-18-00190)
Updated Civil Monetary Penalties and Affirmative Exclusions
06-06-2019
Great Lakes Home Health Services, Inc., Billed for Home Health Services That Did Not Comply With Medicare Coverage and Payment Requirements (A-05-16-00057)
06-05-2019
Testimony of Leslie W. Hollie, Chief of Investigative Operations, Office of Inspector General, U.S. Department of Health and Human Services: U.S. Senate Committee on Finance: Foreign Threats to Taxpayer-Funded Medical Research: Oversight Opportunities and Policy Solutions
Job Openings: Experienced Health Care Attorneys (Associate and Senior Counsel Positions) Deadline to Apply: July 12, 2019
St. Joseph's Hospital and Medical Center Submitted Some Inaccurate Wage Data (A-01-17-00510)
LEIE Database Updated with May 2019 Exclusions and Reinstatements
06-03-2019
Fraud Alert: Genetic Testing Scam
Spring Semiannual Report to Congress

May

05-31-2019
FY18 Health Care Fraud and Abuse Control (HCFAC) Program
05-29-2019
2018 Performance Data for the Senior Medicare Patrol Projects (OEI-02-19-00280)
05-24-2019
Metropolitan Jewish Home Care, Inc., Billed for Home Health Services That Did Not Comply with Medicare Requirements (A-02-16-01001)
Massachusetts Did Not Ensure Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-01-17-00003)
Excella HomeCare Billed for Home Health Services That Did Not Comply With Medicare Coverage and Payment Requirements (A-01-16-00500)
05-23-2019
EHS Home Health Care Service, Inc., Billed for Home Health Services That Did Not Comply With Medicare Coverage and Payment Requirements (A-05-16-00055)
New Jersey Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-02-16-01012)
05-22-2019
Using Health IT for Care Coordination: Insights from Six Medicare Accountable Care Organizations (OEI-01-16-00180)
05-21-2019
Four States Did Not Comply With Federal Waiver and State Requirements in Overseeing Adult Day Care Centers and Foster Care Homes (A-05-19-00005)
05-15-2019
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2018 (OEI-03-19-00040)
Video: Joanne Chiedi's Remarks at the 2019 HCCA Compliance Institute
Updated: Work Plan
05-13-2019
U.S. Department of Health and Human Services Met Many Requirements of the Improper Payments Information Act of 2002 but Did Not Fully Comply for Fiscal Year 2018 (A-17-19-52000)
05-10-2019
California Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries� Deaths (A-04-18-06220)
Updated Corporate Integrity Agreement List
05-09-2019
LEIE Database Updated with April 2019 Exclusions and Reinstatements
05-07-2019
Updated Corporate Integrity Agreement List
05-06-2019
One Percent of Drugs With Medicaid Reimbursement Were Not FDA-Approved (OEI-03-17-00120)
Updated Provider Self-Disclosure Settlements
05-03-2019
Medicaid Could Save Hundreds of Millions by Excluding Authorized Generic Drug Transactions to Secondary Manufacturers from Brand Name Drugs� Average Manufacturer Price Calculations (A-06-18-04002)
05-02-2019
Some Diagnosis Codes That Essence Healthcare, Inc., Submitted to CMS Did Not Comply With Federal Requirements (A-07-17-01170)
Trends in Deficiencies at Nursing Homes Show That Improvements Are Needed To Ensure the Health and Safety of Residents (A-09-18-02010)
Updated Corporate Integrity Agreement List
05-01-2019
The Children's Village, Inc., an Administration for Children and Families Grantee, Did Not Always Comply with Applicable Federal and State Policies and Requirements (A-02-16-02013)

April

04-30-2019
The Centers for Disease Control and Prevention's South Africa Office Generally Implemented Our Prior Audit Recommendation (A-04-18-01009)
04-26-2019
Updated Stipulated Penalties and Exclusion for Material Breach
Updated Civil Monetary Penalties and Affirmative Exclusions
04-25-2019
National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded Between 2013 and 2016 (OEI-07-16-00160)
Updated Corporate Integrity Agreement List
04-19-2019
Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2018 (A-18-18-11200)
04-18-2019
Washington State Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program (A-09-18-01001)
04-17-2019
Concerns About Opioid Use in Medicare Part D in the Appalachian Region (OEI-02-18-00224)
2019 Appalachian Region Opioid Takedown
04-15-2019
Updated: Work Plan
04-11-2019
Factsheet: Texas' Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-06-18-04000)
Indiana Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-17-00038)
Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria—Fiscal Year 2019 Inspectors General Coordinated Oversight Plan
04-10-2019
LEIE Database Updated with March 2019 Exclusions and Reinstatements
04-09-2019
Fraud Alert: Nationwide Brace Scam
Media Materials: Nationwide Brace Scam
04-08-2019
Highlights from Principal Deputy IG Joanne Chiedi's 2019 HCCA Compliance Institute Remarks
The Passamaquoddy Tribe's Pleasant Point Health Center Needs To Improve Its Medical-Referral Process (A-01-17-01503)
Updated Fraud Risk Indicator
Updated Stipulated Penalties and Exclusion for Material Breach
04-05-2019
Although the Administration for Community Living Resolved Nearly All Audit Recommendations, It Did Not Always Do So in Accordance With Federal Timeframe Requirements (A-07-18-03232)
04-04-2019
Updated Corporate Integrity Agreement List
Updated Provider Self-Disclosure Settlements
Grantee Self-Disclosure Settlements
04-02-2019
The Substance Abuse and Mental Health Services Administration Followed Grant Regulations and Program-Specific Requirements When Awarding State Targeted Response to the Opioid Crisis Grants (A-03-17-03302)

March

03-28-2019
New Jersey Did Not Provide Adequate Oversight of Its Medicaid Delivery System Reform Incentive Payment Program (A-02-17-01007)
03-27-2019
New York Did Not Provide Adequate Stewardship of Substance Abuse Prevention and Treatment Block Grant Funds (A-02-17-02009)
Weill Cornell Medicine Monitored Subrecipients and Claimed Allowable National Institutes of Health Award Costs (A-02-17-02006)
03-25-2019
Medicaid Fraud Control Units Fiscal Year 2018 Annual Report (OEI-09-19-00230)
Medicare Market Shares of Non-Mail Order Diabetes Test Strips From April Through June 2018 (OEI-04-18-00441)
Recommendation Followup: Vulnerabilities Continue To Exist in the HHS Small Business Innovation Research Program (OEI-04-18-00230)
Updated Civil Monetary Penalties and Affirmative Exclusions
03-22-2019
Final Rule: Revisions to State Medicaid Fraud Control Unit Rules
03-20-2019
Updated Corporate Integrity Agreement List
03-19-2019
Updated Stipulated Penalties and Exclusion for Material Breach
03-18-2019
FY 2020 Congressional Budget Justification
03-15-2019
Updated: Work Plan
03-13-2019
Summary Report for Office of Inspector General Penetration Testing of Eight HHS Operating Division Networks (A-18-18-08500)
03-12-2019
Factsheet: West Virginia's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-03-18-03302)
Michigan Disbursed Only Part of Its Civil Money Penalty Collections, Limiting Resources To Protect or Improve Care for Nursing Facility Residents (A-05-17-00019)
03-11-2019
LEIE Database Updated with February 2019 Exclusions and Reinstatements
Updated Corporate Integrity Agreement List
03-08-2019
Missouri Claimed Some Unallowable Medicaid Payments for Targeted Case Management Services (A-07-17-03219)
New Mexico Did Not Always Appropriately Refund the Federal Share of Recoveries from Managed Care Organizations (A-06-18-09001)
Updated Provider Self-Disclosure Settlements
03-07-2019
Advisory Opinion 19-03 (regarding a program offered by a medical center that provides free, in-home follow-up care to eligible individuals with congestive heart failure (the "Current Arrangement") and the proposed expansion of this program to include certain individuals with chronic obstructive pulmonary disease)
03-01-2019
Factsheet: New Hampshire's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-01-18-01501)
Updated Civil Monetary Penalties and Affirmative Exclusions

February

02-28-2019
Although the Centers for Disease Control and Prevention Resolved Nearly All Audit Recommendations, It Did Not Always Do So in Accordance With Federal Timeframe Requirements (A-07-17-03226)
02-21-2019
Updated Civil Monetary Penalties and Affirmative Exclusions
02-20-2019
CMS Improperly Paid Millions of Dollars for Skilled Nursing Facility Services When the Medicare 3-Day Inpatient Hospital Stay Requirement Was Not Met (A-05-16-00043)
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2018 (OEI-03-19-00030)
Updated Corporate Integrity Agreement List
02-19-2019
Factsheet: Nevada's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-09-18-01004)
TrustSolutions, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals (A-07-18-00540)
CDC Reimbursed Contractors for Some Unallowable World Trade Center Health Program Administrative Costs (A-02-16-02012)
Updated Corporate Integrity Agreement List
02-15-2019
Updated: Work Plan
Job Opening: Health Information Technology Attorney (Term Appointment), Deadline: March 13, 2019
02-14-2019
Lincoln Hall Boys' Haven, an Administration for Children and Families Grantee, Did Not Always Comply With Applicable Federal and State Policies and Requirements (A-02-16-02007)
02-13-2019
Most Wanted Fugitive Juan Gil Alejo Sentenced to Prison
Opportunities Exist for the National Institutes of Health To Strengthen Controls in Place To Permit and Monitor Access to Its Sensitive Data (A-18-18-09350)
Factsheet: Utah's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-07-18-05115)
Factsheet: Tennessee's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-04-18-00124)
Medicare Compliance Review of Community Hospital (A-05-17-00026)
02-11-2019
CMS Guidance to State Survey Agencies on Verifying Correction of Deficiencies Needs To Be Improved To Help Ensure the Health and Safety of Nursing Home Residents (A-09-18-02000)
Medicare Paid Twice for Ambulance Services Subject to Skilled Nursing Facility Consolidated Billing Requirements (A-01-17-00506)
02-07-2019
Testimony of Ann Maxwell, Assistant Inspector General for Evaluation and Inspections, Office of Inspector General, U.S. Department of Health and Human Services: U.S. House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations: Examining the Failures of the Trump Administration's Inhumane Family Separation Policy
Factsheet: Nebraska's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-07-18-06080)
Updated Civil Monetary Penalties and Affirmative Exclusions
Updated Stipulated Penalties and Exclusion for Material Breach
Updated Provider Self-Disclosure Settlements
02-06-2019
Updated Corporate Integrity Agreement List
02-05-2019
LEIE Database Updated with January 2019 Exclusions and Reinstatements
Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings (A-04-18-06225)
Updated State False Claims Act Review Letters
02-01-2019
Updated Fraud Risk Indicator

January

01-29-2019
Advisory Opinion 19-02 (regarding a pharmaceutical manufacturer's proposal to loan, on a temporary basis, a limited- functionality smartphone to financially needy patients who do not have the technology necessary to receive adherence data from a sensor embedded in prescribed antipsychotic medication)
01-25-2019
Updated Civil Monetary Penalties and Affirmative Exclusions
01-24-2019
Updated Corporate Integrity Agreement List
01-22-2019
Kelley Medical Equipment and Supply, LLC, Received Unallowable Medicare Payments for Orthotic Braces (A-09-17-03030)
01-18-2019
Although the Centers for Medicare & Medicaid Services Has Made Progress, It Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements (A-07-18-03228)
Updated Civil Monetary Penalties and Affirmative Exclusions
01-17-2019
Separated Children Placed in Office of Refugee Resettlement Care (OEI-BL-18-00511)
Featured Topic: Unacommpanied Children
Media Materials: Unaccompanied Children
News Release: HHS OIG: Many Children Separated from Parents, Guardians Before Ms. L. v. Ice Court Order and Some Separations Continue
01-16-2019
Updated: Work Plan
Updated Corporate Integrity Agreement List
01-15-2019
Updated Corporate Integrity Agreement List
01-14-2019
Advisory Opinion 19-01 (regarding a charitable pediatric clinic's arrangement under which the clinic waives cost-sharing amounts in certain circumstances)
Virginia Received Millions in Unallowable Bonus Payments (A-04-17-08060)
Rhode Island Did Not Ensure Its Managed Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-01-17-00004)
New York Has Not Fully Implemented New Criminal Background Check Requirements for Childcare Providers (A-02-17-02011)
01-11-2019
UPDATED: The Tornillo Influx Care Facility: Concerns About Staff Background Checks and Number of Clinicians on Staff
01-10-2019
LEIE Database Updated with December 2018 Exclusions and Reinstatements
Medicare Market Shares of Mail Order Diabetes Test Strips From April Through June 2018 (OEI-04-18-00440)
01-09-2019
Pathways for Children Generally Complied With Health and Safety Requirements (A-01-18-02502)
01-08-2019
Updated Provider Self-Disclosure Settlements
01-07-2019
Most Wanted Fugitive: Betros Garabet
A Queens Chiropractor Received Improper Medicare Payments for Chiropractic Services (A-02-15-01003)
Updated Corporate Integrity Agreement List
01-03-2019
Pacific Medical, Inc., Received Some Unallowable Medicare Payments for Orthotic Braces (A-09-17-03027)
Dialysis Services Provided by Atlantis Health Care Group of Puerto Rico, Inc., Did Not Comply With Medicare Requirements Intended To Ensure the Quality of Care Provided to Medicare Beneficiaries (A-02-16-01009)