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2024

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 pharmaceutical manufacturer.

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 Advantage Compliance Audit of Specific Diagnosis Codes That Triple-S Advantage, Inc., (Contract H5774) Submitted to CMS A-04-21-07095
• Medicare Home Health Agency Provider Compliance Audit: Bridge Home Health A-05-23-00017

12-20-2024

• 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
• Some Selected Skilled Nursing Facilities Did Not Comply With Medicare Requirements for Reporting Related-Party Costs A-07-21-02836
• Updated: Corporate Integrity Agreements
• Updated: CMP and Affirmative Exclusions/EMTALA

12-19-2024

• 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
• 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

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 meningococcal disease.
• 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 may cause kidney stones.
• Updated: Work Plan

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

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

12-05-2024

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

12-04-2024

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

12-03-2024

• 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
• Nonprofit and Government-Owned Nursing Homes Generally Complied With Federal Requirements Regarding the Infection Preventionist Position A-01-24-00002

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

• 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
• 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-place emergency medical services without an associated ambulance transport.

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

• 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
• Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2024 OEI-03-25-00010
• Job Opening: FOIA General Attorney (Associate Counsel)

11-15-2024

• Updated: Work Plan
• Updated: Corporate Integrity Agreements
• Washington State's Oversight Could Better Ensure That Adult Family Homes Comply With Health and Safety and Administrative Requirements A-09-23-02002
• 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

• 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
• Updated: Heightened Scrutiny

11-13-2024

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

11-08-2024

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

11-07-2024

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

11-01-2024

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

October 2024

10-31-2024

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

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

• California Used CARES Act Funds for Unallowable Nutrition Services Program Expenditures A-06-22-01004
• Massachusetts Could Better Ensure That Intermediate Care Facilities for Individuals With Intellectual Disabilities Comply With Federal Requirements for Life Safety and Emergency Preparedness A-01-24-00001

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

• 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
• Updated: CMP and Affirmative Exclusions

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

10-10-2024

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

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

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

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

Additional Oversight of Remote Patient Monitoring in Medicare Is Needed OEI-02-23-00260

Systemic and Operational Challenges Hinder Efforts to Ensure HIV Care for Medicaid Enrollees OEI-05-22-00242

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

Novitas Solutions, Inc., Reopened and Corrected Cost Report Final Settlements With Obvious Errors To Collect Overpayments Made to Medicare Providers A-06-23-05001

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 Plans.

09-12-2024

Updated: Corporate Integrity Agreements

09-11-2024

Featured Topic: The Emergency Medical Treatment and Labor Act (EMTALA)

Updated: Fraud Self-Disclosures

Spring 2025 OIG Health Care Fraud and Abuse Legal Internship

09-10-2024

Most Children in Foster Care Did Not Receive Credit Checks and Assistance OEI-07-22-00510

LEIE Database Updated with August 2024 Exclusions and Reinstatements

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

• 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
• Utah Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements A-07-24-07013

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: Corporate Integrity Agreements
• Updated: CMP and Affirmative Exclusions

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

• Employee Profile: Melissa C. Tucker
• West Virginia Medicaid Fraud Control Unit: 2023 Inspection OEI-09-23-00390
• 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

• 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 services for qualifying patients receiving one of two gene therapy treatments developed by a publicly traded biotechnology company.
• HHS Office of the Secretary Needs to Improve Key Security Controls to Better Protect Certain Cloud Information Systems A-18-22-08018
• Updated: Corporate Integrity Agreements

07-16-2024

• Job Opening: Schedule A Persons with Disability Opportunity: Criminal Investigator GL-1811-09 (Closes July 22)
• ASPR Did Not Consistently Comply With Federal Requirements for Awarding Research and Development Contracts A-03-20-03003
• 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 delay; and (ii) certain discounts to the cost of the drug.

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 gene therapy product and their caregivers.

06-13-2024

• 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
• CMS Could Strengthen Program Safeguards To Prevent and Detect Improper Medicare Payments for Short Inpatient Stays A-09-21-03022

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

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

April 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

• Wanted Fugitive: Dr. Yogeshwar Singh "Garry" Gill
• 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-02-22-02001

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

• 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 2023 A-17-24-52000
• Updated: Corporate Integrity Agreements Office of Counsel
• 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

• 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
• State Agencies Could Be Obtaining Hundreds of Millions in Additional Medicaid Rebates Associated With Physician-Administered Drugs A-07-23-06111

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

• 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
• 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
• Alabama MMIS and E&E System Security Controls Were Adequate, but Some Improvements Are Needed A-18-22-09010

04-04-2024

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

04-03-2024

• 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
• ACF Has Enhanced Some Cybersecurity Controls Over the Unaccompanied Children Portal and Data But Improvements Are Needed A-18-22-03200
• 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

• 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
• 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 Procedures To Enhance Coordination and Alignment A-07-22-04131

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

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

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

• IG Grimm Named Among Top Women Leaders in Health Care
• 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

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

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

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 contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.

02-22-2024

• New: Single Audits - Information and Oversight Activities

02-20-2024

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

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

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

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 Activities and Accompanying Required Assertions A-03-24-00352
• Independent Attestation Review: Indian Health Service Fiscal Year 2023 Detailed Accounting Report and Budget Formulation Compliance Report for National Drug Control Activities, and Accompanying Required Assertions A-03-24-00351
• 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-04-24-02041

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 31, 2018 A-07-22-00627

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-year period, contingent upon the physician partners' agreement to retire from the practice of medicine.
• 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 contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.
• 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 contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.
• 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 potential new physician practice customers.

2023

December

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:

• Fraud Self-Disclosures
• CMP and Affirmative Exclusions

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:

• Fraud Self-Disclosures
• Grant Fraud Self-Disclosures

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:

• CIA Reportable Events
• Fraud Self-Disclosures
• CMP and Affirmative Exclusions

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:

• Civil Monetary Penalties and Affirmative Exclusions
• Fraud Self-Disclosures

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:

• CIA Reportable Events
• Fraud Self-Disclosures

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:

• CMP and Affirmative Exclusions
• CIA Reportable Events
• Fraud Self-Disclosures

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:

• Civil Monetary Penalties and Affirmative Exclusions
• Grant Fraud Self-Disclosures
• Fraud Self-Disclosures

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

---

2022

2022 December

12-28-2022

Advisory Opinion 22-22 (Regarding a pharmaceutical manufacturer's proposal to provide up to a specified number of trial units of a long-acting antipsychotic drug to certain hospitals for inpatient use.)

12-27-2022

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cigna-HealthSpring of Tennessee, Inc. (Contract H4454) Submitted to CMS A-07-19-01193

12-23-2022

Advisory Opinion 22-21 (Regarding an arrangement in which a county and its department of public health's emergency medical services division sublease certain space and lease certain furniture and equipment to a private ambulance company that has been granted an exclusive contract for the provision of emergency ambulance transports in certain parts of the county.)

12-22-2022

National Government Services, Inc., Claimed Some Unallowable Medicare Postretirement Benefit Plan Costs Through Its Incurred Cost Proposals A-07-22-00624

National Government Services, Inc., Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals A-07-22-00625

National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals A-07-22-00628

12-21-2022

Keystone First Should Improve Its Procedures for Reviewing Service Requests That Require Prior Authorization A-03-20-00201

Mandated Analysis of Home Health Service Utilization From January 2016 Through March 2022 A-05-20-00031

Updated: Corporate Integrity Agreements

12-20-2022

For Medicaid-Enrolled Children Diagnosed With Lead Toxicity in Five States, Documentation Reviewed for Diagnoses and Treatment Services Raises Concerns OEI-07-18-00370

New Work Plan Item: Implementation of Inflation-Indexed Rebates for Part B Drugs

12-19-2022

Medicare Part B Spending on Lab Tests Increased in 2021, Driven By Higher Volume of COVID-19 Tests, Genetic Tests, and Chemistry Tests OEI-09-22-00400

Providers Did Not Always Comply With Federal Requirements When Claiming Medicare Bad Debts A-07-20-02825

Advisory Opinion 22-20 (Regarding a hospital's utilization of its employed nurse practitioners to perform services that traditionally have been performed by a patient's attending physician in certain medical units.)

12-16-2022

Intimate Partner Violence Screening and Referral Survey: FAQ

12-15-2022

2022 Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs

Updated: Work Plan

12-14-2022

Updated: Corporate Integrity Agreements

12-13-2022

Updated: Corporate Integrity Agreements

12-12-2022

The Centers for Medicare & Medicaid Services' Review Contractor Did Not Document Medicaid Managed Care Payment Review Determinations Made Under the Payment Error Rate Measurement Program A-04-21-09003

12-09-2022

LEIE Database Updated with November 2022 Exclusions and Reinstatements

12-08-2022

Updated: Corporate Integrity Agreements

12-07-2022

FDA's Approach to Overseeing Online Tobacco Retailers Needs Improvement OEI-01-20-00241

Updated: Civil Monetary Penalties and Affirmative Exclusions

Updated: Fraud Self-Disclosures

12-06-2022

Labs With Questionably High Billing for Additional Tests Alongside COVID-19 Tests Warrant Further Scrutiny OEI-09-20-00510

12-05-2022

Fall 2022 Semiannual Report to Congress

12-01-2022

Insights on Telehealth Use and Program Integrity Risks Across Selected Health Care Programs During the Pandemic OEI-02-22-00150

November

11-25-2022

Medicare Improperly Paid Physicians for Co-Surgery and Assistant-at-Surgery Services That Were Billed Without the Appropriate Payment Modifiers A-01-20-00503

National Government Services, Inc., Accurately Calculated Hospice Cap Amounts but Did Not Collect All Cap Overpayments A-06-21-08004

11-23-2022

Medicare Providers Did Not Always Comply With Federal Requirements When Billing for Advance Care Planning A-06-20-04008

11-22-2022

Puerto Rico MMIS and E&E Systems Security Controls Were Generally Effective, but Some Improvements Are Needed A-18-20-08005

11-18-2022

Updated: Corporate Integrity Agreements

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That BCBS of Rhode Island (Contract H4152) Submitted to CMS A-01-20-00500

The Centers for Medicare & Medicaid Services' Review Contractors Generally Conducted Medicaid Fee-for-Service Claim Reviews for Selected States Under the Payment Error Rate Measurement Program in Accordance with Federal and State Requirements A-04-21-00132

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2022 OEI-03-23-00070

11-17-2022

Long-Term Trends of Psychotropic Drug Use in Nursing Homes OEI-07-20-00500

11-16-2022

2022 Top Management and Performance Challenges Facing HHS

11-15-2022

Updated: Work Plan

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That California Physicians' Service, Inc. (Contract H0504) Submitted to CMS A-09-19-03001

11-14-2022

The Number of Beneficiaries Who Received Medicare Part B Clinical Laboratory Tests Decreased During the First 10 Months of the COVID-19 Pandemic A-09-21-03004

Updated: Civil Monetary Penalties and Affirmative Exclusions

Updated: Fraud Self-Disclosures

Findings of Whistleblower Retaliation by Administration for Children and Families Grantee Management Official

11-10-2022

Employee Profile: Farooq Al-Farooq

LEIE Database Updated with October 2022 Exclusions and Reinstatements

Iowa Implemented Most of Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Major Incidents A-07-21-06105

11-08-2022

Los Desafíos Operativos Dentro de la Oficina de Reasentamiento de Refugiados y el Sitio de Admisión de Emergencia en Fort Bliss Obstaculizaron la Gestión de Casos Para Niños

11-07-2022

Three Tribes in New England and Their Health Programs Did Not Conduct Required Background Investigations on All Individuals in Contact With Indian Children A-01-20-01504

11-04-2022

Updated: Corporate Integrity Agreements

11-03-2022

During the Initial COVID-19 Response, HHS Personnel Who Interacted With Potentially Infected Passengers Had Limited Protections OEI-04-20-00360

October

10-28-2022

Mississippi Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-21-06101

10-27-2022

CMS Can Use OIG Audit Reports To Improve Its Oversight of Hospital Compliance A-04-21-08084

California Made Almost $16 Million in Unallowable Capitation Payments for Beneficiaries With Multiple Client Index Numbers A-04-21-07097

10-26-2022

Colorado Did Not Report and Refund the Correct Federal Share of Medicaid-Related Overpayments for 70 Percent of the State's Medicaid Fraud Control Unit Cases A-07-21-02834

CMS Generally Ensured That Medicare Part C and Part D Sponsors Did Not Pay Ineligible Providers for Services to Medicare Beneficiaries A-02-20-01027

10-25-2022

Payments Made to Providers Under the COVID-19 Accelerated and Advance Payments Program Were Generally in Compliance with the CARES Act and Other Federal Requirements A-05-20-00053

10-21-2022

Updated: Corporate Integrity Agreements

10-18-2022

IHS Did Not Always Provide the Necessary Resources and Assistance To Help Ensure That Tribal Programs Complied With All Requirements During Early COVID-19 Vaccination Program Administration A-07-21-04125

Home Health Agencies Used Multiple Strategies To Respond to the COVID-19 Pandemic, Although Some Challenges Persist OEI-01-21-00110

Updated: Fraud Self-Disclosures

Updated: CMP and Affirmative Exclusions

10-17-2022

Updated: Work Plan

U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement 

10-13-2022

Ciertos beneficiarios de Medicare, como los beneficiarios urbanos e hispanos, fueron más propensos que otros a usar los servicios de telesalud durante el primer año de la pandemia de COVID-19 OEI-02-20-00522

10-12-2022

Updated: Fraud Risk Indicator

10-07-2022

LEIE Database Updated with September 2022 Exclusions and Reinstatements

Texas Claimed or May Have Claimed More Than $30 Million of $9.89 Billion in Federal Funds for Medicaid Uncompensated Care Payments That Did Not Meet Federal and State Requirements 

10-05-2022

Advisory Opinion 22-19 (Regarding a proposal whereby certain pharmaceutical manufacturers would: (i) fund, through Requestor, cost-sharing subsidies for the manufacturers' Part D oncology drugs; (ii) fund, through Requestor, specified programs and eligible beneficiaries' health insurance premiums; and (iii) finance Requestor's operating costs.)

Updated: Corporate Integrity Agreements

10-04-2022

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HumanaChoice (Contract R5826) Submitted to CMS A-05-19-00039

10-03-2022

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Highmark Senior Health Company (Contract H3916) Submitted to CMS A-03-19-00001

CDC's Corrective Actions Improved Program Operations at the National Institute of Health in Mozambique and Facilitated the Institute's Implementation of Prior OIG Audit Recommendations A-04-20-01019

UPICs Hold Promise To Enhance Program Integrity Across Medicare and Medicaid, But Challenges Remain OEI-03-20-00330

September

09-30-2022

Indiana Did Not Comply With Requirements for Documenting Psychotropic and Opioid Medications Prescribed for Children in Foster Care A-05-21-00020

Initial Observations of IHS Capacity to Manage Supplemental $3.5 Billion Appropriated to Sanitation Facilities Construction Projects OEI-06-22-00320

Medicare Advantage Compliance Audit of Diagnosis Codes That Inter Valley Health Plan, Inc. (Contract H0545), Submitted to CMS A-05-18-00020

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That BlueCross BlueShield of Tennessee, Inc. (Contract H7917) Submitted to CMS A-07-19-01195

Medicare Dialysis Services Provider Compliance Audit - Dialysis Clinic, Inc. A-05-20-00010

09-29-2022

Delays in Confirmatory Trials for Drug Applications Granted FDA's Accelerated Approval Raise Concerns OEI-01-21-00401

HHS's and HRSA's Controls Related to Selected Provider Relief Fund Program Requirements Could Be Improved A-09-21-06001

Michigan Medicaid Fraud Control Unit: 2021 Review OEI-06-21-00270

09-28-2022

ACF Should Improve Oversight of Head Start To Better Protect Children's Safety OEI-BL-19-00560

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2020 Average Sales Prices OEI-03-22-00170

HHS Made Some Progress Toward Compliance With the Geospatial Data Act A-18-22-11400

Employee Profile: Omar Pérez Aybar

09-27-2022

Operational Challenges Within ORR and the ORR Emergency Intake Site at Fort Bliss Hindered Case Management for Children OEI-07-21-00251

Medicare Hospice Provider Compliance Audit: Hospice of Palm Beach County, Inc. A-02-20-01001

09-23-2022

NEW: Advisory Opinion Request Template

End-Stage Renal Disease Network Organizations' Reported Actions Taken in Response to the COVID-19 Pandemic A-05-20-00051

CMS's System Edits Significantly Reduced Improper Payments to Acute-Care Hospitals After May 2019 for Outpatient Services Provided to Beneficiaries Who Were Inpatients of Other Facilities A-09-22-03007

09-22-2022

CMS Has Opportunities To Strengthen States' Oversight of Medicaid Managed Care Plans' Reporting of Medical Loss Ratios OEI-03-20-00231

National Institutes of Health Grant Program Cybersecurity Requirements Need Improvement A-18-20-06300

New York Generally Determined Eligibility for Its Basic Health Program Enrollees in Accordance With Program Requirements A-02-20-01028

Updated: Corporate Integrity Agreements

09-21-2022

FDA Repeatedly Adapted Emergency Use Authorization Policies To Address the Need for COVID-19 Testing OEI-01-20-00380

FDA's Work with the Tri-Agency Task Force for Emergency Diagnostics Helped Labs Implement COVID-19 Tests OEI-01-20-00381

Nearly All States Made Capitation Payments for Beneficiaries Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Two States A-05-20-00025

09-20-2022

Medicare Part B Overpaid and Beneficiaries Incurred Cost-Share Overcharges of Over $1 Million for the Same Professional Services A-06-21-05003

IHS's National Supply Service Center Was Generally Effective in Providing Supplies to Facilities During the COVID-19 Pandemic, but Its Internal Controls Could Be Improved A-07-20-04124

Advisory Opinion 22-18 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)

09-19-2022

Certain Life Care Nursing Homes May Not Have Complied With Federal Requirements for Infection Prevention and Control and Emergency Preparedness A-01-20-00004

09-15-2022

Opioid Overdoses and the Limited Treatment of Opioid Use Disorder Continue To Be Concerns for Medicare Beneficiaries OEI-02-22-00390

Tennessee Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-21-06096

Updated: Work Plan

09-13-2022

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Regence BlueCross BlueShield of Oregon (Contract H3817) Submitted to CMS A-09-20-03009

New York Claimed $196 Million, Over 72 Percent of the Audited Amount, in Federal Reimbursement for NEMT Payments to New York City Transportation Providers That Did Not Meet or May Not Have Met Medicaid Requirements A-02-21-01001

09-09-2022

The IHS Telehealth System Was Deployed Without Some Required Cybersecurity Controls A-18-21-03100

Updated: Fraud Self-Disclosures

09-08-2022

LEIE Database Updated with August 2022 Exclusions and Reinstatements

Updated: Corporate Integrity Agreements

09-07-2022

Medicare Telehealth Services During the First Year of the Pandemic: Program Integrity Risks OEI-02-20-00720

Certain Medicare Beneficiaries, Such as Urban and Hispanic Beneficiaries, Were More Likely Than Others To Use Telehealth During the First Year of the COVID-19 Pandemic OEI-02-20-00522

Connecticut Medicaid Fraud Control Unit: 2021 Inspection OEI-06-21-00360

09-06-2022

Reducing Medicare's Payment Rates for Intermittent Urinary Catheters Can Save the Program and Beneficiaries Millions of Dollars Each Year OEI-04-20-00620

Updated: Corporate Integrity Agreements

2023 Spring OIG Health Care Fraud and Abuse Legal Internship

09-02-2022

Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria Fiscal Year 2023 Inspectors General Coordinated PEPFAR Oversight Plan U.S. Department of Health and Human Services, Office of Inspector General A-04-22-01024

HHS Did Not Fully Comply With Federal Requirements and HHS Policies and Procedures When Awarding and Monitoring Contracts for Ventilators A-02-20-02002

09-01-2022

The Municipality of Barceloneta Did Not Always Manage Its Head Start Disaster Assistance Awards in Accordance With Federal and Commonwealth Requirements A-02-20-02003

August

08-31-2022

The Health Resources and Services Administration Should Improve Its Oversight of the Cybersecurity of the Organ Procurement and Transplantation Network A-18-21-11400

08-30-2022

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That WellCare of Florida, Inc., (Contract H1032) Submitted to CMS A-04-19-07084

Montana Claimed Federal Medicaid Reimbursement for More Than $5 Million in Targeted Case Management Services That Did Not Comply With Federal and State Requirements A-07-21-03246

Updated: Corporate Integrity Agreements

08-29-2022

Updated: Corporate Integrity Agreements

08-25-2022

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2022 OEI-03-22-00210

08-24-2022

Nevada's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 9 of 30 Providers Reviewed A-09-21-01000

08-23-2022

Medicare Advantage Compliance Audit of Diagnosis Codes That Cigna HealthSpring of Florida, Inc. (Contract H5410) Submitted to CMS A-03-18-00002

08-22-2022

Updated List: High Risk - Heightened Scrutiny

08-19-2022

Advisory Opinion 22-16 ( Regarding the provision of a gift card to certain Medicare Advantage plan enrollees who complete specific steps in an online patient education program.)

08-17-2022

Updated: Work Plan

08-16-2022

Las imprecisiones en los datos de raza y origen étnico de Medicare dificultan la evaluación de disparidades en la salud OEI-02-21-00100

The National Institutes of Health Did Not Ensure That All Clinical Trial Results Were Reported in Accordance With Federal Requirements A-06-21-07000

08-12-2022

The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2021 in Accordance With Federal Requirements A-04-22-04088

08-11-2022

Part D Plan Preference for Higher-Cost Hepatitis C Drugs Led to Higher Medicare and Beneficiary Spending OEI-BL-21-00200

South Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-21-07003

Updated: Corporate Integrity Agreements

08-05-2022

Updated:

• CIA Reportable Events
• Fraud Self-Disclosures
• CMP and Affirmative Exclusions

Updated: Corporate Integrity Agreements

08-03-2022

Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2021 A-18-22-11300

08-02-2022

Updated: Fraud Risk Indicator

08-01-2022

Statement on the Passing of Former Inspector General June Gibbs Brown

LEIE Database Updated with July 2022 Exclusions and Reinstatements

July

07-29-2022

Certain Nursing Homes May Not Have Complied With Federal Requirements for Infection Prevention and Control and Emergency Preparedness A-01-20-00005

07-28-2022

Employee Profile: Eyana J. Esters

CMS Reported Collecting Just Over Half of the $498 Million in Medicare Overpayments Identified by OIG Audits A-04-18-03085

Updated: Civil Monetary Penalties and Affirmative Exclusions

07-21-2022

Medicare Critical Care Services Provider Compliance Audit: Lahey Clinic, Inc. A-03-20-00002

07-20-2022

Special Fraud Alert: OIG Alerts Practitioners To Exercise Caution When Entering Into Arrangements With Purported Telemedicine Companies

2022 National Health Care Fraud Enforcement Action

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cariten Health Plan, Inc., (Contract H4461) Submitted to CMS A-02-20-01009

07-19-2022

Updated: Corporate Integrity Agreements

07-18-2022

Updated: Work Plan

Audits of Nursing Home Life Safety and Emergency Preparedness in Eight States Identified Noncompliance With Federal Requirements and Opportunities for the Centers for Medicare & Medicaid Services to Improve Resident, Visitor, and Staff Safety A-02-21-01010

Job Openings: Office of Counsel Attorney Positions

07-15-2022

CDC Found Ways To Use Data To Understand and Address COVID-19 Health Disparities, Despite Challenges With Existing Data OEI-05-20-00540

Medicare Hospice Provider Compliance Audit: Vitas Healthcare Corporation of Florida A-02-19-01018

07-14-2022

Updated: Fraud Self-Disclosures

07-08-2022

LEIE Database Updated with June 2022 Exclusions and Reinstatements

Updated: Corporate Integrity Agreements

07-07-2022

In Five States, There Was No Evidence That Many Children in Foster Care Had a Screening for Sex Trafficking When They Returned After Going Missing OEI-07-19-00371

07-06-2022

The Reduced Outlier Threshold Applied to Transfer Claims Did Not Significantly Increase Medicare Payments to Hospitals A-05-19-00019

07-05-2022

2021 Health Care Fraud and Abuse Control Program Report

Advisory Opinion 22-15 (Regarding a proposal to use donations to cover: (i) specialized care furnished to veterans who meet certain criteria; and (ii) certain out-of-pocket expenses related to that specialized care. )

07-01-2022

The Centers for Medicare & Medicaid Services Had Policies and Procedures in Place To Mitigate Vulnerabilities in a Timely Manner, but Improvements Are Needed A-18-20-06500

Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2022 OEI-05-22-00230

June

06-29-2022

The Food and Drug Administration's Foreign For-Cause Drug Inspection Program Can Be Improved To Protect the Nation's Drug Supply A-01-19-01500

Advisory Opinion 22-14 (regarding an ophthalmology practice's proposed continuing education programs for local optometrists and four financing options to fund the programs.)

Justice Department's Criminal Division Creates New England Prescription Opioid Strike Force to Focus on Illegal Opioid Prescriptions

06-28-2022

Testimony of Erin Bliss, Assistant Inspector General, Office of Evaluation and Inspections, Office of Inspector General, United States House Committee on Energy and Commerce Subcommittee on Oversight and Investigations, Testimony to Protecting America's Seniors: Oversight of Private Sector Medicare Advantage Plans

More Than 90 Percent of the New Hampshire Managed Care Organization and Fee-for-Service Claims for Opioid Treatment Program Services Did Not Comply With Medicaid Requirements A-01-20-00006

06-27-2022

An Estimated 91 Percent of Nursing Home Staff Nationwide Received the Required COVID-19 Vaccine Doses, and an Estimated 56 Percent of Staff Nationwide Received a Booster Dose A-09-22-02003

06-23-2022

Office of Refugee Resettlement's Influx Care Facility and Emergency Intake Sites Did Not Adequately Safeguard Unaccompanied Children From COVID-19 A-06-21-07002

Advisory Opinion 22-13 (regarding a durable medical equipment manufacturer's arrangements with two financial institutions to make zero-interest financing available to qualified customers.)

06-22-2022

Updated: Corporate Integrity Agreements

06-21-2022

Iowa Medicaid Fraud Control Unit: 2021 Inspection OEI-07-21-00340

Updated: Corporate Integrity Agreements

Updated: Civil Monetary Penalties and Affirmative Exclusions

06-16-2022

STAT Op-Ed by Christi A. Grimm, Ruth Ann Dorrill, & Julie K. Taitsman: New report: gains in patient safety have stalled over the past decade

06-15-2022

Inaccuracies in Medicare's Race and Ethnicity Data Hinder the Ability To Assess Health Disparities OEI-02-21-00100

Eye on Oversight Video: Inaccuracies in Medicare's Race and Ethnicity Data

Updated: Work Plan

06-14-2022

2021 Performance Data for the Senior Medicare Patrol Projects OEI-02-22-00310

06-13-2022

Medicare and Beneficiaries Paid Substantially More to Provider-Based Facilities in Eight Selected States in Calendar Years 2010 Through 2017 Than They Paid to Freestanding Facilities in the Same States for the Same Type of Services A-07-18-02815

Updated: Corporate Integrity Agreements

06-10-2022

LEIE Database Updated with May 2022 Exclusions and Reinstatements

06-08-2022

Updated: Fraud Self-Disclosures

06-07-2022

Opportunities Exist To Strengthen NIH Grantees' Oversight of Investigators' Foreign Significant Financial Interests and Other Support OEI-03-20-00210

Maine Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents A-01-20-00007

06-06-2022

Spring 2022 Semiannual Report to Congress

California Collected and Disbursed Stimulus Payments and Income Tax Refunds Under the Federal Tax Refund Offset Program in Accordance With Federal and State Requirements A-01-21-01501

06-03-2022

Texas Did Not Report and Return All Medicaid Overpayments for the State's Medicaid Fraud Control Unit's Cases A-06-20-04004

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Peoples Health Network (Contract H1961) Submitted to CMS A-06-18-05002

06-02-2022

Updated Work Plan: Food and Drug Administration's Actions Regarding the Abbott Infant Formula Recall

Cost Allocation Services Needs To Update Its Indirect Cost Rate-Setting Guidance 06-01-2022

Vanderbilt University Medical Center: Audit of Outpatient Outlier Payments A-06-20-04003

06-01-2022

Medicare Improperly Paid Durable Medical Equipment Suppliers an Estimated $8 Million of the $40 Million Paid for Power Mobility Device Repairs A-09-20-03016

Advisory Opinion 22-12 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay. )

Modification of Advisory Opinion 20-02 (Requestor now seeks to modify 20-02 to include Requestor's provision of financial assistance to eligible patients for travel, lodging, and certain other associated expenses in connection with a round trip to an approved treatment center for a cell-removal process associated with manufacturing Requestor's drug.)

May

05-27-2022

Updated: Corporate Integrity Agreements

05-26-2022

Selected Dialysis Companies Implemented Additional Infection Control Policies and Procedures To Protect Beneficiaries and Employees During the COVID-19 Pandemic A-05-20-00052

05-25-2022

Advisory Opinion 22-11 (Regarding its proposal to employ an individual who is excluded from participation in Federal health care programs to perform marketing tasks relating to workers' compensation programs.)

05-23-2022

Press Release: HHS-OIG Issues Notice of Exclusion to Owner of 7 Louisiana Nursing Homes

National Snapshot of State Agency Approaches To Reporting and Locating Children Missing From Foster Care A-07-20-06095

05-19-2022

Employee Profile: Jessica Yun Kim

05-17-2022

New AI/AN Training: Improving Health and Well-Being in American Indian and Alaska Native Communities Through Compliance

Washington State Did Not Comply With Federal and State Requirements for Claiming Enhanced Federal Reimbursement for Medicaid Managed-Care Health Home Service Expenditures A-09-20-02008

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2021 OEI-03-22-00200

05-16-2022

Updated: Work Plan

05-12-2022

Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm in October 2018 OEI-06-18-00400

National Background Check Program for Long-Term-Care Providers: An Interim Assessment OEI-07-20-00181

05-11-2022

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 2021 A-17-22-52000

05-10-2022

LEIE Database Updated with April 2022 Exclusions and Reinstatements

05-06-2022

2022 Fall OIG Health Care Fraud and Abuse Legal Internship

05-05-2022

Employee Profile: Jim Korn

Updated: Corporate Integrity Agreements

Updated: Fraud Self-Disclosures

05-04-2022

2022 Opioid Enforcement Action

HHS Should Improve Internal Coordination Regarding Unaccompanied Children OEI-BL-20-00670

05-03-2022

Updated: Civil Monetary Penalties and Affirmative Exclusions

05-02-2022

Advisory Opinion 22-10 - Modification of Advisory Opinion 15-14 (Regarding (i) a modification to OIG Advisory Opinion 15-14, issued to the requestor on November 13, 2015, to include within the scope of that opinion, the requestor's proposal to provide financial assistance for certain past magnetic resonance imaging tests; and (ii) a second arrangement regarding the distribution of certain cooling and mobility items, ancillary to the arrangement addressed in OIG Advisory Opinion 15-14.)

April

04-28-2022

Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care OEI-09-18-00260

Eye on Oversight Video: Medicare Advantage Denials of Care

National Snapshot of Trends in the National Domestic Violence Hotline's Contact Data Before and During the COVID-19 Pandemic A-09-21-06000

Advisory Opinion 22-09 (Regarding a proposed arrangement pursuant to which Requestor would compensate hospitals for certain specimen collection services for laboratory tests furnished by Requestor.)

04-27-2022

Advisory Opinion 22-08 (Regarding an arrangement whereby certain existing patients of Requestor use limited-use smartphones that Requestor loaned to such patients to facilitate access to telehealth services.)

Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2021 A-18-21-11200

04-26-2022

Massachusetts Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents A-01-20-00003

04-25-2022

Advisory Opinion 22-07 (Regarding an arrangement whereby certain physicians have an ownership interest in a medical device company that manufactures products that may be ordered by the physician owners and a physician spouse of one of the physician owners.)

04-22-2022

California Improperly Claimed at Least $23 Million of $260 Million in Total Medicaid Reimbursement for Opioid Treatment Program Services A-09-20-02009

04-21-2022

Updated: Fraud Risk Indicator

04-20-2022

2022 National COVID-19 Health Care Fraud Enforcement Action

04-18-2022

Updated: Corporate Integrity Agreements

04-15-2022

Updated: Work Plan

04-14-2022

Updated: Corporate Integrity Agreements

04-11-2022

Louisiana Faced Compliance and Contracting Challenges in Implementing Opioid Response Grant Programs A-06-20-07003

Advisory Opinion 22-06 Regarding the provision of free genetic testing and genetic counseling services to individuals who meet specified clinical criteria.

Updated: Corporate Integrity Agreements

04-08-2022

LEIE Database Updated with March 2022 Exclusions and Reinstatements

Posthospital Skilled Nursing Facility Care Provided to Dually Eligible Beneficiaries in Indiana Generally Met Medicare Level-of-Care Requirements A-05-20-00005

04-07-2022

New COVID-19 Enforcement Action

Updated: CIA Reportable Events, CMP and Affirmative Exclusions, and Fraud Self-Disclosures

04-06-2022

Updated: Corporate Integrity Agreements

04-05-2022

Featured Topic: Telehealth

04-04-2022

South Carolina Did Not Fully Comply With Requirements for Reporting and Monitoring Critical Events Involving Medicaid Beneficiaries With Developmental Disabilities A-04-18-07078

March

03-31-2022

Medicare Part D and Beneficiaries Could Realize Significant Spending Reductions With Increased Biosimilar Use OEI-05-20-00480

03-30-2022

Inspector General Grimm HCCA 26th Annual Compliance Institute Keynote

Psychotherapy Services Billed by a New York City Provider Did Not Comply With Medicare Requirements A-02-21-01006

03-28-2022

FY 2023 Congressional Budget Justification

Employee Profile: Rosemary Bartholomew

03-22-2022

New Mexico Did Not Claim $12.4 Million of $222.6 Million in Medicaid Payments for Services Provided by Indian Health Service Facilities in Accordance With Federal and State Requirements A-06-19-09005

03-17-2022

Telehealth Was Critical for Providing Services to Medicare Beneficiaries During the First Year of the COVID-19 Pandemic OEI-02-20-00520

Updated: Civil Monetary Penalties and Affirmative Exclusions

New COVID-19 Enforcement Action

03-16-2022

Advisory Opinion 22-05 Regarding the proposed subsidization of certain Medicare cost-sharing obligations in the context of a clinical trial.

New York Verified That Medicaid Assisted Living Program Providers Met Life Safety and Emergency Planning Requirements But Did Not Always Ensure That Assisted Living Program Services Met Federal and State Requirements A-02-19-01017

03-15-2022

Updated: Work Plan

Medicaid Fraud Control Units Fiscal Year 2021 Annual Report OEI-09-22-00020

03-10-2022

New Video: Our Impact: HHS-OIG

LEIE Database Updated with February 2022 Exclusions and Reinstatements

New Jersey's Medicaid School-Based Cost Settlement Process Could Result in Claims That Do Not Meet Federal Requirements A-02-20-01012

03-08-2022

Updated: Corporate Integrity Agreements

Updated: Fraud Self-Disclosures

03-04-2022

The Centers for Medicare & Medicaid Services' Eligibility Review Contractor Adequately Determined Medicaid Eligibility for Selected States Under the Payment Error Rate Measurement Program A-02-20-01006

New COVID-19 Enforcement Action

03-03-2022

Updated: Corporate Integrity Agreements

03-02-2022

Leadership Update

Advisory Opinion 22-04 (Regarding a program through which Requestor provides certain individuals access to digital contingency management and related tools to treat substance use disorders, where the Program is funded by customers, which could include individuals' health care providers or suppliers.)

03-01-2022

Texas Did Not Ensure Documentation Supported That Individuals Met Eligibility Requirements and That Its Annual Report Was Accurate Under Its Projects for Assistance in Transition From Homelessness Program A-02-21-02001

February

02-23-2022

Employee Profile: Angela Grimes

Hospitals Did Not Always Meet Differing Medicare Contractor Specifications for Bariatric Surgery A-09-20-03007

Office of Inspector General's Partnership With the Oregon Secretary of State's Audits Division: Oregon Health Authority-Timely Notification of Inpatient Hospital Stays Could Help Reduce Improper Medicaid Payments A-09-22-02001

02-18-2022

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2021 OEI-03-22-00190

Updated: Corporate Integrity Agreements

02-17-2022

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Tufts Health Plan (Contract H2256) Submitted to CMS A-01-19-00500

02-16-2022

Medicare Payments of $6.6 Billion to Nonhospice Providers Over 10 Years for Items and Services Provided to Hospice Beneficiaries Suggest the Need for Increased Oversight A-09-20-03015

Updated: Work Plan

02-14-2022

Office of Refugee Resettlement Generally Ensured That Selected Care Provider Facilities for Its Unaccompanied Children Program Complied With Federal Emergency Preparedness Requirements A-04-20-02025

Advisory Opinion 22-03 (Regarding Requestors' proposal to pay salaries to, and nurse aide certification program tuition costs on behalf of, new employees who Requestors have hired to work as certified nurse aides for Requestors' home health agencies.)

02-10-2022

LEIE Database Updated with January 2022 Exclusions and Reinstatements

Updated: Health Care Fraud Self-Disclosures

02-09-2022

Advisory Opinion 22-02 (Regarding a proposed arrangement between Requestor and two individuals, pursuant to which Requestor and the individuals would reduce and subsidize certain costs incurred by qualifying patients of Requestor's children's hospital.)

The National Institutes of Health Could Improve Its Post-Award Process for the Oversight and Monitoring of Grant Awards A-03-20-03001

02-08-2022

Findings of Whistleblower Retaliation by CDC Central America Regional HIV Program Management Official

02-07-2022

Updated: Corporate Integrity Agreements

02-04-2022

Medicare Advantage Compliance Audit of Diagnosis Codes That SCAN Health Plan (Contract H5425) Submitted to CMS A-07-17-01169

Updated: Civil Monetary Penalties and Affirmative Exclusions

02-03-2022

Prior Audits of Medicaid Eligibility Determinations in Four States Identified Millions of Beneficiaries Who Did Not or May Not Have Met Eligibility Requirements A-02-20-01018

02-02-2022

Updated: Corporate Integrity Agreements

Updated: Fraud Risk Indicator

02-01-2022

Independent Attestation Report: Food and Drug Administration Budget Formulation Compliance Report and Detailed Accounting Submission for Fiscal Year 2021 National Drug Control Activities, and Accompanying Required Assertions A-03-22-00352

January

01-27-2022

The Assistant Secretary for Administration Awarded and Managed Five Sole Source Contracts for COVID-19 Testing in Accordance With Federal and Contract Requirements A-05-21-00014

HHS's Suspension and Debarment Program Helped Safeguard Federal Funding, But Opportunities for Improvement Exist OEI-04-19-00570

01-26-2022

Independent Attestation Review: Centers for Medicare & Medicaid Services Fiscal Year 2021 Detailed Accounting Submission and Budget Formulation Compliance Report for National Drug Control Activities, and Accompanying Required Assertions A-03-22-00351

01-24-2022

New COVID-19 Enforcement Action

Updated: Civil Monetary Penalties and Affirmative Exclusions

01-19-2022

Advisory Opinion 22-01 (Regarding the proposed expansion of discount programs for low-income individuals.)

01-18-2022

CMS Should Take Further Action To Address States With Poor Performance in Conducting Nursing Home Surveys OEI-06-19-00460

Updated: Corporate Integrity Agreements

Updated: Work Plan

01-14-2022

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-04-21-06254

New COVID-19 Enforcement Action

01-13-2022

Updated: Corporate Integrity Agreements

01-12-2022

Updated: Health Care Fraud Self-Disclosures

01-11-2022

Updated: CMP and Affirmative Exclusions and CIA Reportable Events

01-10-2022

LEIE Database Updated with December 2021 Exclusions and Reinstatements

Updated: Corporate Integrity Agreements

01-07-2022

Job Openings: Office of Counsel Attorney Positions

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Healthfirst Health Plan, Inc., (Contract H3359) Submitted to CMS A-02-18-01029

01-06-2022

Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Assets as of December 31, 2016 A-07-21-00603

Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2014 Through 2016 A-07-21-00602

Updated: Corporate Integrity Agreements

01-05-2022

Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals for Calendar Years 2014 Through 2016 A-07-21-00605

Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Postretirement Benefit Assets as of January 1, 2017 A-07-21-00604

01-04-2022

COVID-19 Tests Drove an Increase in Total Medicare Part B Spending on Lab Tests in 2020, While Use of Non-COVID-19 Tests Decreased Significantly OEI-09-21-00240

Louisiana's Monitoring Did Not Ensure Child Care Provider Compliance With Criminal Background Check Requirements at 8 of 30 Providers Reviewed A-06-19-02001

---

2021

December

12-30-2021

Medicare and Beneficiaries Pay More for Preadmission Services at Affiliated Hospitals Than at Wholly Owned Settings OEI-05-19-00380

12-23-2021

Arkansas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-01003

12-21-2021

Trends in Genetic Tests Provided Under Medicare Part B Indicate Areas of Possible Concern A-09-20-03027

12-20-2021

Medicare Hospital Provider Compliance Audit: St. Joseph's Hospital Health Center A-02-20-01004

The Food and Drug Administration Needs To Improve Its Contract Closeout Processes To Identify Contracts Eligible for Closeout and Close Contracts Timely A-03-20-03004

12-17-2021

Updated: Corporate Integrity Agreements

12-16-2021

Many Medicare Beneficiaries Are Not Receiving Medication to Treat Their Opioid Use Disorder

Advisory Opinion 21-20 (Regarding Requestor's proposal to create an online platform for: (i) users to search for and contact home-based health care providers, where providers listed on the website would be charged on a per-click basis; and (ii) advertising by individuals and entities other than home-based health care providers.)

12-15-2021

Updated: Work Plan

12-14-2021

Updated Corporate Integrity Agreements FAQ: Should Reportable Events also be disclosed to the OIG's Self-Disclosure Protocol?

12-10-2021

Medicare Could Have Saved Approximately $993 Million in 2017 and 2018 if It Had Implemented an Inpatient Rehabilitation Facility Transfer Payment Policy for Early Discharges to Home Health Agencies A-01-20-00501

12-09-2021

LEIE Database Updated with November 2021 Exclusions and Reinstatements

Updated: Corporate Integrity Agreements

Updated: CMP and Affirmative Exclusions and Health Care Fraud Self-Disclosures

12-08-2021

Video: HHS-OIG 2021 Year in Review

12-07-2021

Updated: Corporate Integrity Agreements

12-06-2021

New COVID-19 Enforcement Actions

Medicare Improperly Paid Physicians for Spinal Facet-Joint Denervation Sessions A-09-21-03002

Advisory Opinion 21-19 (Regarding Requestor's provision of free eye drops that mitigate side effects for patients using one of its products.)

12-03-2021

Kentucky Made Almost $2 Million in Unallowable Capitation Payments for Beneficiaries With Multiple Medicaid ID Numbers A-04-20-07094

12-02-2021

2021 Fall Semiannual Report to Congress

Taxpayers Could Save Nearly $4 Billion Dollars as a Result of HHS-OIG Work in FY 2021

Updated: Corporate Integrity Agreements

New COVID-19 Work Plan Item

November

11-24-2021

CMS Should Strengthen Its Prescription Drug Event Guidance To Clarify Reporting of Sponsor Margin for Medicare Part D Bids A-03-17-00001

11-23-2021

The Office of Intergovernmental and External Affairs Needs To Improve Internal Controls Over Its Travel Card Program A-03-19-00501

11-22-2021

Facility-Initiated Discharges in Nursing Homes Require Further Attention OEI-01-18-00250

New COVID-19 Enforcement Action

Advisory Opinion 21-18 (Regarding a proposed joint venture for the provision of therapy services.)

11-19-2021

Updated: Work Plan

Advisory Opinion 21-17 (Regarding the proposed subsidization of beneficiary cost-sharing obligations for Medicare-covered services provided as part of a clinical trial.)

11-18-2021

Missouri Properly Converted Provisionally Enrolled Medicaid Providers to Permanent Providers A-07-21-03248

Medicare Improperly Paid Suppliers an Estimated $117 Million Over 4 Years for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Hospice Beneficiaries A-09-20-03026

11-16-2021

2021 Top Management and Performance Challenges Facing HHS

Characteristics of Separated Children in ORR's Care: June 27, 2018–November 15, 2020 OEI-BL-20-00680

Advisory Opinion 21-16 (Regarding a pharmaceutical manufacturer's arrangement to provide up to a specified number of trial units of a long-acting antipsychotic drug to certain hospitals for inpatient use.)

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2021 OEI-03-22-00060

11-10-2021

New COVID-19 Enforcement Action

Updated: Corporate Integrity Agreements

Advisory Opinion 21-15 (Regarding a pain management company's proposal to retain net profits from services provided by an employed certified registered nurse anesthetist pursuant to a reassignment of billing rights.)

11-09-2021

LEIE Database Updated with October 2021 Exclusions and Reinstatements

Updated: Health Care Fraud Self-Disclosures

11-08-2021

Updated: Health Care Fraud Self-Disclosure Protocol

The District of Columbia's Monitoring Did Not Ensure Child Care Provider Compliance With Criminal Background Check Requirements at 7 of 30 Providers Reviewed A-03-20-00252

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UPMC Health Plan, Inc. (Contract H3907) Submitted to CMS A-07-19-01188

Michigan Did Not Report Calendar Year 2019 Medicaid Third-Party Liability Cost Avoidance Data to the Centers for Medicare & Medicaid Services A-05-20-00058

11-04-2021

Two Critical HHS Systems Were Deployed Without Authorizations to Operate

Updated: CMP and Affirmative Exclusions and Updated Stipulated Penalties and Exclusion for Material Breach

New COVID-19 Enforcement Action

11-03-2021

Updated: Corporate Integrity Agreements

11-02-2021

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health Care of Missouri, Inc. (Contract H2663) Submitted to CMS A-07-17-01173

October

10-28-2021

Office of Inspector General's Partnership With the Commonwealth of Massachusetts Office of the State Auditor: Office of Medicaid (MassHealth) - Payments for Hospice-Related Services for Dual-Eligible Members A-01-20-00001

10-27-2021

2021 Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs

10-26-2021

Updated: Corporate Integrity Agreements

10-25-2021

The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2020 in Accordance With Federal Requirements A-04-21-04081

Video: HHS-OIG is Working for You

10-21-2021

Tennessee Medicaid Claimed Hundreds of Millions of Federal Funds for Certified Public Expenditures That Were Not in Compliance With Federal Requirements A-04-19-04070

Updated: Fraud Risk Indicator

10-20-2021

More Than One-Third of Medicaid-Enrolled Children in Five States Did Not Receive Required Blood Lead Screening Tests OEI-07-18-00371

Most Medicare beneficiaries received telehealth services only from providers with whom they had an established relationship OEI-02-20-00521

Annual Inflation Updates to the Annual Cap on Patient Engagement Tools and Supports Under 42 CFR § 1001.952(hh)

10-19-2021

New COVID-19 Work Plan Item

Updated: Work Plan

10-15-2021

A Look at Drug Spending

10-14-2021

Changes Made to States' Medicaid Programs To Ensure Beneficiary Access to Prescriptions During the COVID-19 Pandemic A-06-20-04007

10-13-2021

U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement A-17-21-54000

10-08-2021

Minnesota Medicaid Managed Care Entities Used a Majority of Medicaid Funds Received for Medical Expenses and Quality Improvement Activities A-05-18-00018

10-07-2021

LEIE Database Updated with September 2021 Exclusions and Reinstatements

Updated: Corporate Integrity Agreements

10-06-2021

Updated: CMP and Affirmative Exclusions and Provider Self Disclosures

Updated: Corporate Integrity Agreements

10-05-2021

Medicare Overpaid $636 Million for Neurostimulator Implantation Surgeries A-01-18-00500

SAMHSA's Oversight Generally Ensured That the Commission on Accreditation of Rehabilitation Facilities Verified That Opioid Treatment Programs Met Federal Opioid Treatment Standards A-09-20-01002

Advisory Opinion 21-14 (Regarding a proposal to extend an existing discount program for chiropractic patients to include Federal health care program beneficiaries.)

10-04-2021

Advisory Opinion 21-13 (Regarding the proposed subsidization of beneficiary cost-sharing obligations for Medicare-covered services provided as part of a clinical trial.)

10-01-2021

Updated: Corporate Integrity Agreements

September

09-30-2021

Case Study: Missouri's Efforts To Protect Children Missing From Foster Care OEI-07-19-00372

High-expenditure Medicare drugs often qualified for Orphan Drug Act incentives designed to encourage the development of treatments for rare diseases OEI-BL-20-00080

New COVID-19 Enforcement Action

09-29-2021

New COVID-19 Enforcement Actions

09-27-2021

PDIG Grimm American Health Law Association Fraud and Compliance Forum Keynote

Six of Eight Home Health Agency Providers Had Infection Control Policies and Procedures That Complied With CMS Requirements and Followed CMS COVID-19 Guidance To Safeguard Medicare Beneficiaries, Caregivers, and Staff During the COVID-19 Pandemic A-01-20-00508

Updated: Corporate Integrity Agreements

09-23-2021

California Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-09-19-02004

About Seventy-Nine Percent of Opioid Treatment Program Services Provided to Medicaid Beneficiaries in Colorado Did Not Meet Federal and State Requirements A-07-20-04118

09-22-2021

Request for Information: Modernization Initiative To Improve HHS-OIG Public Resources

Some Medicare Advantage Companies Leveraged Chart Reviews and Health Risk Assessments To Disproportionately Drive Payments OEI-03-17-00474

09-21-2021

Opportunities Exist To Strengthen Evaluation and Oversight of Telehealth for Behavioral Health in Medicaid OEI-02-19-00401

States Reported Multiple Challenges With Using Telehealth To Provide Behavioral Health Services to Medicaid Enrollees OEI-02-19-00400

Indian Health Service Use of Critical Care Response Teams Has Helped To Meet Facility Needs During the COVID-19 Pandemic OEI-06-20-00700

New Mexico Medicaid Fraud Control Unit: 2020 Review OEI-06-20-00550

09-17-2021

2021 National Health Care Fraud Enforcement Action

Updated: Work Plan

09-16-2021

HHS Needs to Improve Contingency Planning Oversight of its IT Systems A-18-20-04007

09-15-2021

Advisory Opinion 21-12 (Regarding a critical access hospital's proposal to offer an arrangement similar to a warranty to patients undergoing certain joint replacement procedures at the hospital.)

09-14-2021

Updated: Corporate Integrity Agreements

09-13-2021

New COVID-19 Enforcement Action

09-10-2021

LEIE Database Updated with August 2021 Exclusions and Reinstatements

An Ophthalmology Clinic in Florida: Audit of Medicare Payments for Eye Injections of Avastin, Eylea, and Lucentis A-09-19-03025

2022 Spring OIG Health Care Fraud and Abuse Legal Internship

09-09-2021

Colorado Did Not Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-17-06075

South Carolina Medicaid Fraud Control Unit: 2020 Inspection OEI-02-20-00610

09-03-2021

CMS's COVID-19 Data Included Required Information From the Vast Majority of Nursing Homes, but CMS Could Take Actions To Improve Completeness and Accuracy of the Data A-09-20-02005

Updated: Corporate Integrity Agreements

09-02-2021

Kansas Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-07-20-05125

09-01-2021

Medicare Beneficiaries Hospitalized With COVID-19 Experienced a Wide Range of Serious, Complex Conditions OEI-02-20-00410

The National Human Genome Research Institute Should Strengthen Procedures in Its Pre-Award Process To Assess Risk for Certain Foreign and Higher Risk Applicants A-05-20-00026

August

08-31-2021

Updated: Corporate Integrity Agreements

08-27-2021

CGS Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-21-00613

Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria: Fiscal Year 2022 Inspectors General Coordinated PEPFAR Oversight Plan A-04-21-01023

08-26-2021

CMS Needs To Issue Regulations Related to Phlebotomy Travel Allowances A-06-20-04000

CGS Administrators, LLC, Claimed Some Unallowable Medicare Excess Plan Costs Through Its Incurred Cost Proposals A-07-21-00612

08-25-2021

Job Opening: Associate Counsel for Exclusions

08-24-2021

Although CDC Implemented Our Prior Audit Recommendations, Its Corrective Actions Did Not Effectively Address Findings Related to 3 of Our 13 Recommendations A-04-19-01014

08-23-2021

Oklahoma's Oversight of Medicaid Outpatient Services for Opioid Use Disorder Was Generally Effective A-06-20-08000

08-20-2021

Medicare Home Health Agency Provider Compliance Audit: Catholic Home Care A-02-19-01013

08-19-2021

Advisory Opinion 21-11 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company contracts with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, provides a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay. )

Medicare Hospital Provider Compliance Audit: Jewish Hospital A-04-19-08077

CGS Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-20-00593

CGS Administrators, LLC, Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan III Costs Through Its Incurred Cost Proposals A-07-21-00608

Louisiana Medicaid Fraud Control Unit: 2020 Inspection OEI-12-20-00650

08-17-2021

New COVID-19 Enforcement Action

Updated: Corporate Integrity Agreements

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2021 OEI-03-21-00080

Mississippi Medicaid Fraud Control Unit: 2020 Inspection OEI-12-20-00200

08-16-2021

Updated: COVID-19 Fraud Alert Information

Medicare Paid New Hospitals Three Times More for Their Capital Costs Than They Would Have Been Paid Under the Inpatient Prospective Payment System A-07-19-02818

Missouri Claimed Federal Reimbursement for $3.4 Million in Payments to Health Home Providers That Did Not Meet Medicaid Requirements A-07-20-04117

Updated: Work Plan

08-13-2021

Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Excess Plan Costs Through Its Incurred Cost Proposals A-07-21-00616

08-12-2021

Concerns Persist about Opioid Overdoses and Medicare Beneficiaries' Access to Treatment and Overdose-Reversal Drugs OEI-02-20-00401

Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan III Costs Through Its Incurred Cost Proposals A-07-21-00615

Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-21-00614

Companion Data Services, LLC, Supplemental Executive Retirement Plan III Costs Claimed Through Incurred Cost Proposals Were Allowable and Reasonable A-07-21-00611

08-11-2021

Companion Data Services, LLC, Claimed Some Unallowable Medicare Excess Plan Costs Through Its Incurred Cost Proposals A-07-21-00610

Companion Data Services, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-21-00609

Palmetto Government Benefits Administrator, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-20-00592

08-10-2021

LEIE Database Updated with July 2021 Exclusions and Reinstatements

Updated: CMP and Affirmative Exclusions and Provider Self Disclosures

Almost All of the Medicare Pension Costs That Companion Data Services, LLC, Claimed Through Its Incurred Cost Proposals Were Allowable A-07-20-00594

08-09-2021

Updated: COVID-19 Fraud Alert Information

Medicare Continues To Make Overpayments for Chronic Care Management Services, Costing the Program and Its Beneficiaries Millions of Dollars A-07-19-05122

08-06-2021

Advisory Opinion 21-10 (Regarding a dental provider's provision of free routine and emergency dental services to certain indigent residents of skilled nursing facilities and nursing facilities.)

Nationwide, Almost All Medicaid Managed Care Plans Achieved Their Medical Loss Ratio Targets OEI-03-20-00230

08-04-2021

Updated: Work Plan

Updated: Corporate Integrity Agreements

08-02-2021

Almost 15 Percent of Arkansas' Private Contractor Costs Were Either Unallowable or Claimed at Higher Federal Matching Rates Than Eligible, Resulting in Arkansas Inappropriately Claiming $4.4 Million in Federal Medicaid Funds A-06-18-09002

Updated: Work Plan

July

07-29-2021

States' Backlogs of Standard Surveys of Nursing Homes Grew Substantially During the COVID-19 Pandemic OEI-01-20-00431

07-23-2021

Texas Made Unallowable Children's Health Insurance Program Payments for Beneficiaries Assigned More Than One Identification Number A-06-20-10003

07-22-2021

Palmetto GBA, LLC, Accurately Calculated Hospice Cap Amounts but Did Not Collect All Cap Overpayments A-06-19-08003

New York Improperly Claimed $439 Million In Medicaid Funds for Its School-Based Health Services Based on Certified Public Expenditures A-02-18-01019

07-21-2021

Updated: COVID-19 Fraud Alert Information

Updated: Corporate Integrity Agreements

07-20-2021

Updated: Fraud Risk Indicator

07-19-2021

Advisory Opinion 21-09 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)

07-15-2021

New COVID-19 Enforcement Action

Updated: Work Plan

Updated: Corporate Integrity Agreements

07-14-2021

FY 2020 Health Care Fraud and Abuse Control Program Report

Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2020 A-18-21-11300

Audit of Medicare Part D Pharmacy Fees: Group Health Cooperative, Inc. A-03-19-00002

Medicare Hospice Provider Compliance Audit: Partners In Care, Inc. A-09-18-03024

07-12-2021

Medicare Hospice Provider Compliance Audit: Mission Hospice & Home Care, Inc. A-09-18-03009

Indiana Received Over $22 Million in Excess Federal Funds Related to Unsupported Community Integration and Habilitation Waiver Services at 12 Selected Service Providers A-05-19-00022

Medicare Hospital Provider Compliance Audit: Lake Hospital System A-05-19-00024

07-09-2021

The Centers for Medicare & Medicaid Services Did Not Account for National Security Risks in Its Enterprise Risk Management Processes A-18-20-06200

Medicare Payments for Transitional Care Management Services Generally Complied With Federal Requirements, but Some Overpayments Were Made A-07-17-05100

New York's Claims for Federal Reimbursement for Payments to Health Home Providers on Behalf of Beneficiaries Diagnosed With Serious Mental Illness or Substance Use Disorder Generally Met Medicaid Requirements But It Still Made $6 Million in Improper Payments to Some Providers A-02-19-01007

LEIE Database Updated with June 2021 Exclusions and Reinstatements

07-08-2021

The National Heart, Lung, and Blood Institute Did Not Fully Comply With Federal Requirements for Other Transactions A-04-20-04078

Advisory Opinion 21-08 (Regarding financial assistance for transportation, lodging, and meals provided by a pharmaceutical manufacturer to certain patients potentially eligible for treatment with the pharmaceutical manufacturer's drug. )

Updated: Provider Self Disclosures

Updated: Corporate Integrity Agreements

07-07-2021

The Puerto Rico Department of Health's Implementation of Its Emergency Preparedness and Response Activities Before and After Hurricane Maria Was Not Effective 

Advisory Opinion 21-07 (Regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay. )

07-06-2021

PDIG Grimm Provides Update on Oversight of COVID-19-Related Programs

June

06-30-2021

2020 Performance Data for the Senior Medicare Patrol Projects OEI-02-21-00180

Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2021 OEI-05-21-00170

06-29-2021

Advisory Opinion 21-06 (Regarding a spinal implant manufacturer�s proposal to offer its products to hospitals at a reduced price if the hospitals agree to assume certain duties related to the products.)

Updated: Civil Monetary Penalties and Affirmative Exclusions

06-28-2021

CMS's Controls Related to Hospital Preparedness for an Emerging Infectious Disease Were Well-Designed and Implemented but Its Authority Is Not Sufficient for It To Ensure Preparedness at Accredited Hospitals A-02-21-01003

Medicare Hospital Provider Compliance Audit: Staten Island University Hospital A-02-18-01025

06-25-2021

Kentucky Claimed Millions in Unallowable School-Based Medicaid Administrative Costs A-04-17-00113

Medicare Hospice Provider Compliance Audit: Northwest Hospice, LLC A-09-20-03035

06-23-2021

Medicare Lacks Consistent Oversight of Cybersecurity for Networked Medical Devices in Hospitals OEI-01-20-00220

06-22-2021

COVID-19 Had a Devastating Impact on Medicare Beneficiaries in Nursing Homes During 2020 OEI-02-20-00490

New Featured Topic: Nursing Homes

06-16-2021

SAMHSA Is Missing Opportunities To Better Monitor Access to Medication Assisted Treatment Through the Buprenorphine Waiver Program OEI-BL-20-00260

06-15-2021

Updated: Work Plan

Selected NIH Institutes Met Requirements for Documenting Peer Review But Could Do More To Track and Explain Funding Decisions OEI-01-19-00140

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2019 Average Sales Prices OEI-03-21-00130

06-14-2021

California Did Not Ensure That Nursing Facilities Always Reported Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Properly A-09-19-02005

Nebraska Did Not Report and Refund the Correct Federal Share of Medicaid-Related Overpayments for 76 Percent of the State's Medicaid Fraud Control Unit Cases A-07-18-02814

06-11-2021

Medicare Hospice Provider Compliance Audit: Professional Healthcare at Home, LLC A-09-18-03028

06-09-2021

Opportunities Exist for CMS and Its Medicare Contractors To Strengthen Program Safeguards To Prevent and Detect Improper Payments for Drug Testing Services A-09-20-03017

Updated: Provider Self Disclosures

06-08-2021

LEIE Database Updated with May 2021 Exclusions and Reinstatements

06-04-2021

University of Michigan Health System: Audit of Medicare Payments for Polysomnography Services A-04-20-07088

Updated: Corporate Integrity Agreements

06-03-2021

New Mexico Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-06-16-00001

New COVID-19 Enforcement Action

Updated: Work Plan

06-01-2021

Medicare Home Health Agency Provider Compliance Audit: Caretenders of Jacksonville, LLC A-04-16-06195

Gateway Community Action Partnership Claimed Unallowable Costs, Did Not Comply With Federal Regulations on Construction and Major Renovations, and Did Not Accurately Account for Grant Funds A-02-18-02011

May

05-28-2021

FY 2022 Congressional Budget Justification

Spring 2021 Semiannual Report to Congress

Updated: Corporate Integrity Agreements

05-27-2021

Toolkit: Insights from OIG's Work on the Office of Refugee Resettlement's Efforts To Care for Unaccompanied Children OEI-09-21-00220

Blue Cross Blue Shield of South Carolina Overstated Its Excess Plan Partial Medicare Segment Pension Assets as of January 1, 2017 A-07-21-00607

Medicare Made Millions of Dollars in Overpayments for End-Stage Renal Disease Monthly Capitation Payments A-07-19-05117

Updated: Corporate Integrity Agreements

05-26-2021

2021 National COVID-19 Health Care Fraud Takedown

05-24-2021

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Anthem Community Insurance Company, Inc. (Contract H3655) Submitted to CMS A-07-19-01187

Updated COVID-19 FAQs

05-21-2021

Sleep Management, LLC: Audit of Claims for Monthly Rental of Noninvasive Home Ventilators A-04-18-04066

05-20-2021

Medicare Hospice Provider Compliance Audit: Franciscan Hospice A-09-20-03034

Updated: Corporate Integrity Agreements

Advisory Opinion 21-05 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)

05-19-2021

New York Did Not Have Adequate Oversight of Its Reported Temporary Assistance for Needy Families Program Expenditures A-02-17-02005

Advisory Opinion 21-04 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)

05-18-2021

Medicare Hospice Provider Compliance Audit: Alive Hospice, Inc. A-09-18-03016

Medicare Hospice Provider Compliance Audit: Ambercare Hospice, Inc. A-09-18-03017

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2020 OEI-03-21-00070

New COVID-19 Enforcement Action

05-17-2021

NEW: Behavioral Health-Medication-Assisted Treatment Viewer

Updated: Work Plan

U.S. 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 Fiscal Year 2020 A-17-21-52000

CMS Needs to Strengthen Regulatory Requirements for Medicare Part B Outpatient Cardiac and Pulmonary Rehabilitation Services to Ensure Providers Fully Meet Coverage Requirements A-02-18-01026

Advisory Opinion 21-03 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract with a preferred hospital organization to provide discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay.)

05-14-2021

Minnesota Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00032

05-13-2021

New York Made Unallowable Payments Totaling More Than $9 Million to the Same Managed Care Organization for Beneficiaries Assigned More Than One Medicaid Identification Number A-02-20-01007

05-12-2021

Medicare Could Have Saved up to $20 Million Over 5 Years if CMS Oversight Had Been Adequate To Prevent Payments for Medically Unnecessary Cholesterol Blood Tests A-09-19-03027

05-11-2021

Risk Assessment of the Food and Drug Administration's Travel Card Program A-04-19-06235

Updated: Corporate Integrity Agreements

New COVID-19 Enforcement Action

05-10-2021

Medicare Hospice Provider Compliance Audit: Suncoast Hospice A-02-18-01001

05-07-2021

Louisiana Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-02005

The Substance Abuse and Mental Health Services Administration Generally Had Controls and Strategies for Mitigating Disaster Preparedness and Response Risks A-04-20-02026

Updated: Corporate Integrity Agreements

05-06-2021

CMS Could Improve the Data It Uses To Monitor Antipsychotic Drugs in Nursing Homes OEI-07-19-00490

Updated: CIA Reportable Events and Provider Self Disclosures

05-05-2021

Updated COVID-19 FAQs

Medicare Hospital Provider Compliance Audit: Virtua Our Lady of Lourdes Hospital A-02-18-01018

Updated: Corporate Integrity Agreements

05-03-2021

LEIE Database Updated with April 2021 Exclusions and Reinstatements

April

04-29-2021

New Video: HHS-OIG Update on Compliance

Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Maryland A-03-17-00009

Advisory Opinion 21-02 (regarding an investment by a health system, certain surgeons, and a management company in an ambulatory surgery center.)

04-27-2021

Louisiana Appropriately Claimed Most Balancing Incentive Payment Program Funds A-06-19-02000

Updated: Civil Monetary Penalties and Affirmative Exclusions

04-26-2021

Updated: Corporate Integrity Agreements

04-23-2021

Office of Inspector General's Partnership with the Office of the New York State Comptroller: Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare A-02-21-01008

New Whistleblower Protection Information Brochure

04-22-2021

HHS-OIG Update on Compliance: Principal Deputy Inspector General Christi A. Grimm speaks at the HCCA 25th Annual Compliance Institute

Testimony of Gary L. Cantrell, Deputy Inspector General, Office of Investigations, Office of Inspector General, U.S. House Committee on Health, Education, Labor and Pensions: Protecting U.S. Biomedical Research: Efforts to Prevent Undue Foreign Influence

04-21-2021

Colorado's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 18 of 30 Providers Reviewed A-07-19-06084

04-20-2021

Medicare Advantage Compliance Audit of Diagnosis Codes That Humana, Inc., (Contract H1036) Submitted to CMS A-07-16-01165

04-16-2021

Updated: Fraud Risk Indicator

04-15-2021

Message from HHS-OIG Leadership on the COVID-19 Vaccination Program and Provider Compliance

Mensaje de la PDIG sobre el programa de vacunaci�n contra el COVID-19 y (acatamiento) del proveedor

Updated: Work Plan

04-13-2021

Georgia Generally Ensured That Nursing Facilities Reported Allegations of Potential Abuse or Neglect of Medicaid Beneficiaries and Prioritized Allegations Timely A-04-17-03084

04-12-2021

Blue Cross Blue Shield of South Carolina Overstated Its Supplemental Executive Retirement Plan III Medicare Allowable Segment Pension Assets as of January 1, 2017 A-07-20-00600

Updated: Corporate Integrity Agreements

04-09-2021

CNN Op-Ed by Christi A. Grimm & Michael E. Horowitz: Four crucial lessons for improving Covid-19 testing

New COVID-19 Enforcement Actions

Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2020 A-18-20-11200

Palmetto Government Benefits Administrator, LLC, Overstated Its Excess Plan Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00598

Noridian Healthcare Solutions, LLC, Claimed Unallowable Medicare Nonqualified Restoration Savings Plan Costs Through Its Incurred Cost Proposals A-07-20-00591

Updated: Civil Monetary Penalties and Affirmative Exclusions, CIA Reportable Events, and Provider Self Disclosures

04-07-2021

Summary Report for Cybersecurity Assessments of Four HHS Operating Division Networks A-18-20-08012

04-06-2021

Medicare Advantage Organizations Are Missing Opportunities To Use Ordering Provider Identifiers To Protect Program Integrity OEI-03-19-00432

04-01-2021

Medicare Hospital Provider Compliance Audit: Sunrise Hospital & Medical Center A-04-19-08075

March

03-30-2021

An Ophthalmology Clinic in California: Audit of Medicare Payments for Eye Injections of Eylea and Lucentis A-09-19-03022

Data on Medicaid Managed Care Payments to Providers Are Incomplete and Inaccurate OEI-02-19-00180

03-29-2021

Illinois Medicaid Fraud Control Unit: 2019 Onsite Review OEI-06-19-00510

03-25-2021

Companion Data Services, LLC, Properly Updated Its Excess Plan Medicare Segment Pension Assets as of January 1, 2017 A-07-21-00606

Updated: Corporate Integrity Agreements

03-24-2021

Hospitals Reported That the COVID-19 Pandemic Has Significantly Strained Health Care Delivery OEI-09-21-00140

Updated: COVID-19 FAQs

Advisory Opinion 21-01 (regarding a free drug provided by a pharmaceutical manufacturer to certain patients to whom the manufacturer's drug has been prescribed.)

03-19-2021

Medicaid Fraud Control Units Fiscal Year 2020 Annual Report OEI-09-21-00120

03-18-2021

North Mississippi Medical Center: Audit of Medicare Payments for Polysomnography Services A-04-19-07086

Updated: Corporate Integrity Agreements

03-15-2021

Updated: Work Plan

03-12-2021

HHS Operating Division Generally Implemented Cybersecurity Controls Over Key Reporting System But Improvements Are Needed A-18-20-06001

03-11-2021

CMS Use of Data on Nursing Home Staffing: Progress and Opportunities To Do More OEI-04-18-00451

03-10-2021

LEIE Database Updated with February 2021 Exclusions and Reinstatements

03-08-2021

Peninsula Regional Medical Center: Audit of Medicare Payments for Polysomnography Services A-04-19-07087

Florida Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Assess, Prioritize, or Investigate Reported Incidents A-04-17-08058

Updated: Provider Self-Disclosure Settlements

Updated: Civil Monetary Penalties and Affirmative Exclusions

Updated: Grant Fraud Self-Disclosure Settlements

03-05-2021

Updated COVID-19 Fraud Alert Information

Updated: Corporate Integrity Agreements

03-03-2021

CMS Authorized Hundreds of Millions of Dollars in Advanced Premium Tax Credits on Behalf of Enrollees Who Did Not Make Their Required Premium Payments A-02-19-02005

Updated: Corporate Integrity Agreements

03-02-2021

ACF Cannot Ensure That All Child Victims of Abuse and Neglect Have Court Representation OEI-12-16-00120

03-01-2021

STAT Op-Ed by Christi A. Grimm & Julie K. Taitsman: Why drug prescriptions should include diagnoses

February

02-26-2021

Message from HHS-OIG Leadership on Telehealth

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Blue Cross Blue Shield of Michigan (Contract H9572) Submitted to CMS A-02-18-01028

Updated: Corporate Integrity Agreements

2021 Fall OIG Health Care Fraud and Abuse Legal Internship

02-24-2021

Medicare Hospice Provider Compliance Audit: Tidewell Hospice, Inc. A-02-18-01024

Virginia's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 8 of 30 Providers Reviewed A-03-19-00253

Trend Toward More Expensive Inpatient Hospital Stays in Medicare Emerged Before COVID-19 and Warrants Further Scrutiny OEI-02-18-00380

Updated: Corporate Integrity Agreements

02-23-2021

Although the Bemidji Area Office Had Adequate Procedures To Disburse Indian Health Service Funds, It Needs To Strengthen Its Procedures for Monitoring the Use of the Funds A-05-18-00019

02-22-2021

Noridian Healthcare Solutions, LLC, Made Improper Medicare Payments of $4 Million to Physicians in Jurisdiction E for Spinal Facet-Joint Injections A-09-20-03010

02-18-2021

Updated: Provider Self-Disclosure Settlements

02-17-2021

New York Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-02-17-01026

Updated: Corporate Integrity Agreements

Updated: COVID-19 FAQs

02-16-2021

Iowa Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-07-19-03238

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2020 OEI-03-21-00060

Updated: Work Plan

02-11-2021

Illinois Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00031

02-10-2021

LEIE Database Updated with January 2021 Exclusions and Reinstatements

02-04-2021

Opioid Use in Medicare Part D During the Onset of the COVID-19 Pandemic OEI-02-20-00400

Updated: Corporate Integrity Agreements

02-02-2021

Updated Stipulated Penalties and Exclusion for Material Breach

Updated Civil Monetary Penalties and Affirmative Exclusions

January

01-29-2021

Louisiana Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries A-06-18-02000

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-04-21-06248

Updated: Work Plan

01-28-2021

California Claimed at Least $2 Million in Unallowable Medicaid Reimbursement for a Selected Provider's Opioid Treatment Program Services A-09-20-02001

Massachusetts Made at Least $14 Million in Improper Medicaid Payments for the Nonemergency Medical Transportation Program A-01-19-00004

01-25-2021

Updated Provider Self-Disclosure Settlements

Updated: Corporate Integrity Agreements

01-20-2021

Choctaw Nation of Oklahoma Made Progress Toward Meeting Program Goals During the First Year of Its Tribal Opioid Response Grant A-07-20-04121

01-21-2021

Independent Attestation Review: Substance Abuse and Mental Health Services Administration Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00353

01-20-2021

Updated: Work Plan

01-19-2021

CMS and Its Contractors Did Not Use Comprehensive Error Rate Testing Program Data To Identify and Focus on Error-Prone Providers A-05-17-00023

01-15-2021

Medicare Home Health Agency Provider Compliance Audit: Southeastern Home Health Services

Updated: Work Plan

01-14-2021

Federal COVID-19 Testing Report: Data Insights from Six Federal Health Programs

• Press Release

Updated: Fraud Risk Indicator

01-13-2021

Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00355

Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00354

Independent Attestation Review: National Institutes of Health Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00352

Independent Attestation Review: Indian Health Service Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00351

01-08-2021

Updated: Corporate Integrity Agreements

01-07-2021

LEIE Database Updated with December 2020 Exclusions and Reinstatements

Ohio Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program A-05-18-00004

01-05-2021

Updated: Corporate Integrity Agreements

---

2020

December

12-31-2020

The Centers for Medicare & Medicaid Services Could Improve Its Wage Index Adjustment for Hospitals in Areas With the Lowest Wages 

Advisory Opinion 20-09 (regarding a program where a pharmaceutical manufacturer provides financial assistance for travel, lodging, and other expenses to certain patients prescribed the manufacturer's drug)

12-30-2020

Advisory Opinion 20-08 (regarding a federally qualified health center�s proposal to offer gift cards to incentivize certain pediatric patients to attend rescheduled preventive and early intervention care appointments)

12-29-2020

Updated: Corporate Integrity Agreements

12-28-2020

Advisory Opinion 20-07 (regarding a web-based platform where health care facilities and clinicians would, in particular circumstances, remit to patients and the patients' payors a portion of the claims for certain services for which payment may be made by the Medicare program as a secondary payor)

Medicare Home Health Agency Provider Compliance Audit: Tender Touch Health Care Services A-04-18-07077

States Could Do More to Oversee Spending and Contain Medicaid Costs for Specialty Drugs OEI-03-17-00430

12-23-2020

Advisory Opinion 20-06 (regarding a management company's provision of below fair market value Medicaid enrollment application assistance services to certain individuals and affiliated skilled nursing facilities' payments for those services in particular circumstances)

Aspects of Texas' Quality Incentive Payment Program Raise Questions About Its Ability To Promote Economy and Efficiency in the Medicaid Program A-06-18-07001

12-22-2020

Onsite Surveys of Nursing Homes During the COVID-19 Pandemic: March 23-May 30, 2020 OEI-01-20-00430

Despite Savings on Many Lab Tests in 2019, Total Medicare Spending Increased Slightly Because of Increased Utilization for Certain High-Priced Tests OEI-09-20-00450

12-21-2020

The Office of Refugee Resettlement Did Not Award and Manage the Homestead Influx Care Facility Contracts in Accordance With Federal Requirements A-12-20-20001

Indian Health Service Facilities Made Progress Incorporating Patient Protection Policies, but Challenges Remain OEI-06-19-00331

Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Tullahoma, Tennessee A-02-16-01024

Updated: Corporate Integrity Agreements

12-18-2020

Medicare Hospital Provider Compliance Audit: Providence Medical Center A-07-18-05113

12-16-2020

Opioids in Medicaid: Concerns About Opioid Use Among Beneficiaries in Six Appalachian States OEI-05-19-00410

Medicare Home Health Agency Provider Compliance Audit: Total Patient Care Home Health, LLC A-06-16-05005

HHS Operating Division Needs to Improve Controls Over Key Application to Protect Sensitive Data A-18-19-06002

12-15-2020

Updated: Work Plan

12-14-2020

Incidence of Adverse Events in Indian Health Service Hospitals OEI-06-17-00530

Instances of IHS Labor and Delivery Care Not Following National Clinical Guidelines or Best Practices OEI-06-19-00190

Although CDC Implemented Corrective Actions To Improve Oversight of the President's Emergency Plan for AIDS Relief Recipients, Some Internal Control Weaknesses Remained A-04-18-01010

Risk Assessment Puerto Rico Medicaid Program A-02-20-01011

Updated COVID-19 FAQs

12-11-2020

New York Improved Its Monitoring of Its Personal Care Services Program But Still Made Improper Medicaid Payments of More Than $54 Million A-02-19-01016

12-10-2020

Updated COVID-19 FAQs

LEIE Database Updated with November 2020 Exclusions and Reinstatements

Few Patients Received High Amounts of Opioids from IHS-Run Pharmacies OEI-05-18-00470

The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2019 in Accordance With Federal Requirements A-04-20-04077

12-09-2020

Updated Stipulated Penalties and Exclusion for Material Breach

Updated Provider Self-Disclosure Settlements

Updated Civil Monetary Penalties and Affirmative Exclusions

12-08-2020

New York Provided Projects for Assistance in Transition From Homelessness Grant Services to Ineligible Individuals and Did Not Contribute Any Required Non-Federal Funds A-02-19-02006

12-04-2020

Updated: Corporate Integrity Agreements

12-03-2020

Updated COVID-19 Fraud Alert

12-02-2020

2020 Fall Semiannual Report to Congress

Press Release: HHS-OIG�s Work Could Save Taxpayers Billions of Dollars, New Report Says

Nebraska Claimed Almost All Medicaid Payments for Targeted Case Management Services in Accordance With Federal Requirements but Claimed Some Unallowable Duplicate Payments A-07-19-03239

November

11-27-2020

Florida Received Unallowable Medicaid Reimbursement for School-Based Services A-04-18-07075

11-24-2020

U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement A-17-20-54000

11-23-2020

Opioid Treatment Programs Reported Challenges Encountered During the COVID-19 Pandemic and Actions Taken To Address Them A-09-20-01001

Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Payson, Arizona. A-02-16-01023

Updated COVID-19 Fraud Alert

11-20-2020

Final Rule: Medicare and State Health Care Programs: Fraud and Abuse; Revisions to Safe Harbors under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements

• Fact Sheet: Final Rule: Revisions to the Safe Harbors Under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements

Medicare Home Health Agency Provider Compliance Audit: The Palace at Home A-04-17-07067

Updated: Corporate Integrity Agreements

11-19-2020

Ohio Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00023

Medicare Hospital Provider Compliance Audit: Edward W. Sparrow Hospital A-05-18-00045

11-18-2020

Cahaba Government Benefits Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00577

Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00578

Hospitals Did Not Comply With Medicare Requirements for Reporting Cardiac Device Credits A-01-18-00502

11-17-2020

2020 Top Management and Performance Challenges Facing HHS

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2020 OEI-03-21-00050

11-16-2020

Updated: Work Plan

Special Fraud Alert: Speaker Programs

In Selected States, 67 of 100 Health Centers Did Not Use Their HRSA Access Increases in Mental Health and Substance Abuse Services Grant Funding in Accordance With Federal Requirements A-02-19-02001

Updated: Corporate Integrity Agreements

11-12-2020

Ohio Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries A-05-18-00027

Updated: Corporate Integrity Agreements

11-10-2020

Advocating for the Nation's Elder Population: Operation CARE

Updated: Corporate Integrity Agreements

LEIE Database Updated with October 2020 Exclusions and Reinstatements

11-09-2020

Office of Refugee Resettlement Ensured That Selected Care Providers Were Prepared To Respond to the COVID-19 Pandemic A-04-20-02031

11-06-2020

Cahaba Government Benefits Administrators, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00575

Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00576

CMS Did Not Ensure That Medicare Hospital Payments for Claims That Included Medical Device Credits Were Reduced in Accordance With Federal Regulations, Resulting in as Much as $35 Million in Overpayments A-07-19-00560

11-03-2020

Updated: Corporate Integrity Agreements

11-02-2020

Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Central Jersey Home Care and Hospice, Inc. A-02-17-01025

Updated: Corporate Integrity Agreements

October

10-30-2020

Minnesota Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00018

Medicare Hospital Provider Compliance Audit: St Francis Hospital A-05-18-00048

10-27-2020

Updated: Corporate Integrity Agreements

10-26-2020

Updated: Work Plan

Massachusetts Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-06-18-04001

Updated: Corporate Integrity Agreements

10-23-2020

Medicare Home Health Agency Provider Compliance Audit: Gem City Home Care, LLC A-05-18-00011

10-16-2020

Cedars-Sinai Medical Center: Audit of Medicare Payments for Bariatric Surgeries A-09-18-03010

10-15-2020

Updated: Work Plan

10-13-2020

Medicare Improperly Paid Physicians for More Than Five Spinal Facet-Joint Injection Sessions During a Rolling 12-Month Period A-09-20-03003

10-09-2020

Update on Oversight of Opioid Prescribing and Monitoring of Opioid Use: States Have Taken Action To Address the Opioid Epidemic A-09-20-01000

Updated: Fraud Risk Indicator

10-08-2020

LEIE Database Updated with September 2020 Exclusions and Reinstatements

Remarks: 2020 Health Care Fraud Takedown

10-07-2020

Updated: Corporate Integrity Agreements

10-06-2020

HHS Made Some Progress Toward Compliance With the Geospatial Data Act A-18-20-11500

Colorado Improperly Claimed Millions in Enhanced Federal Medicaid Reimbursement for New Adult Group Beneficiaries Because of a Data Processing Error A-07-17-02807

Medicare Critical Care Services Provider Compliance Audit: Clinical Practices of the University of Pennsylvania A-03-18-00003

10-05-2020

Speech: Connecting the Dots: An OIG Update, by Christi A. Grimm, Principal Deputy Inspector General

10-02-2020

Risk Assessment of Food and Drug Administration's Purchase Card Program A-04-19-06234

Medicare Hospital Provider Compliance Audit: Alta Bates Summit Medical Center A-04-19-08071

Updated: Corporate Integrity Agreements

10-01-2020

Updated: Work Plan

National Snapshot of State Agency Approaches to Child Care During the COVID-19 Pandemic A-07-20-06092

Youth For Tomorrow - New Life Center, Inc., an Administration for Children and Families Grantee, Did Not Comply With All Applicable Federal Policies and Requirements A-03-16-00250

September

09-30-2020

2020 National Health Care Fraud Takedown

09-29-2020

FDA's Risk Evaluation and Mitigation Strategies: Uncertain Effectiveness in Addressing the Opioid Crisis OEI-01-17-00510

North Carolina Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-04-16-00112

09-28-2020

Healthcare Dive Op-Ed by Christi A. Grimm: Medicare Advantage should not 'game the system' but prioritize patient care, honest billing

Updated: Corporate Integrity Agreements

09-25-2020

States Continued To Fall Short in Meeting Required Timeframes for Investigating Nursing Home Complaints: 2016-2018 OEI-01-19-00421

09-24-2020

Updated: Corporate Integrity Agreements

Connecticut Did Not Meet Federal and State Requirements for Claiming Medicaid School-Based Child Health Services for Hartford Public Schools A-01-19-00003

CMS's Monitoring Activities for Ensuring That Medicare Accountable Care Organizations Report Complete and Accurate Data on Quality Measures Were Generally Effective, but There Were Weaknesses That Could Be Improved A-09-18-03033

09-23-2020

Advisory Opinion 20-05 (regarding a pharmaceutical manufacturer's proposal to provide cost-sharing assistance directly to Medicare beneficiaries who are prescribed either of two formulations of its drug)

CMS Should Pursue Strategies To Increase the Number of At Risk Beneficiaries Acquiring Naloxone Through Medicaid OEI-BL-18-00360

Arkansas Medicaid Fraud Control Unit: 2019 Onsite Inspection OEI-12-19-00450

Oregon's Oversight Did Not Ensure That Four Coordinated-Care Organizations Complied With Selected Medicaid Requirements Related to Access to Care and Quality of Care A-09-18-03035

Updated: Corporate Integrity Agreements

09-22-2020

North Carolina Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-19-08070

Vermont Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-19-06086

09-21-2020

Updated: Work Plan

Updated: Corporate Integrity Agreements

Illinois Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-05-18-00037

Incorrect Acute Stroke Diagnosis Codes Submitted by Traditional Medicare Providers Resulted in Millions of Dollars in Increased Payments to Medicare Advantage Organizations A-07-17-01176

09-18-2020

Updated: Corporate Integrity Agreements

Medicare-Allowed Charges for Noninvasive Ventilators Are Substantially Higher Than Payment Rates of Select Non-Medicare Payers A-05-20-00008

Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals A-07-20-00590

09-17-2020

Southwest Key Programs Failed To Protect Federal Funds Intended for the Care and Placement of Unaccompanied Alien Children A-06-17-07004

Indiana Did Not Ensure That Medicaid Payments Were Made Properly for Some Claims Identified as Having Third-Party Coverage A-05-18-00046

Medicare Home Health Agency Provider Compliance Audit: Mercy Health Visiting Nurse Services A-05-18-00035

09-16-2020

Maine Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-18-06079

Group Health Incorporated Overstated Its Allowable Medicare Supplemental Executive Retirement Plan Costs for Calendar Years 2009 Through 2016 A-07-19-00582

Group Health Incorporated Claimed Some Unallowable Medicare Postretirement Benefit Costs for Calendar Years 2009 Through 2016  A-07-19-00583

09-15-2020

Updated: Work Plan

Group Health Incorporated Overstated Its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of December 31, 2015 A-07-19-00579

Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of August 31, 2016 A-07-19-00580

Group Health Incorporated Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2009 Through 2016 A-07-19-00581

Some Manufacturers Reported Inaccurate Drug Product Data to CMS OEI-03-19-00200

09-14-2020

The National Institutes of Health Should Improve Its Stewardship and Accountability Over Hardware and Software Assets A-18-19-06004

09-11-2020

Baylor Scott & White—College Station: Audit of Outpatient Outlier Payments A-06-18-04003

09-10-2020

LEIE Database Updated with August 2020 Exclusions and Reinstatements

Billions in Estimated Medicare Advantage Payments From Diagnoses Reported Only on Health Risk Assessments Raise Concerns OEI-03-17-00471

Updated: Provider Self-Disclosure Settlements

09-09-2020

Updated Civil Monetary Penalties and Affirmative Exclusions

Audit of Medicare Part D Pharmacy Fees: Horizon Blue Cross Blue Shield, Inc. A-03-18-00007

09-04-2020

Hawaii's Monitoring Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements A-09-19-01000

National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded in 2019 OEI-07-20-00180

09-03-2020

Updated COVID-19 FAQs

Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group A-07-19-02822

Medicare Hospital Provider Compliance Audit: Flagstaff Medical Center A-07-18-05112

09-02-2020

Tribal Health Programs: Concerns About Background Verifications for Staff Working With Indian Children A-01-20-01500

CMS Generally Met Requirements for the DMEPOS Competitive Bidding Program Round 1 Recompete A-05-16-00051

09-01-2020

Indiana's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 17 of 30 Providers Reviewed A-05-19-00012

Michigan Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00017

Illinois Claimed Unallowable Telemedicine Payments  A-05-18-00028

Indiana Paid $3.5 Million for Medicaid Nonemergency Medical Transport Claims That Did Not Comply With Federal and State Requirements A-05-18-00043

August

08-31-2020

Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria Fiscal Year 2021 Inspectors General Coordinated PEPFAR Oversight Plan U.S. Department of Health and Human Services, Office of Inspector General  A-04-20-01017

08-28-2020

Updated: Work Plan

Texas Relied on Impermissible Provider-Related Donations To Fund the State Share of the Medicaid Delivery System Reform Incentive Payment Program A-06-17-09002

08-27-2020

Medicare Contractors Were Not Consistent in How They Reviewed Extrapolated Overpayments in the Provider Appeals Process A-05-18-00024

08-26-2020

Updated: Work Plan

CMS's Encounter Data Lack Essential Information That Medicare Advantage Organizations Have the Ability to Collect OEI-03-19-00430

08-25-2020

Indiana Properly Reported Adjustments Related to the Drug Rebate Program A-05-19-00028

08-24-2020

Updated: Corporate Integrity Agreements

08-21-2020

Rhode Island's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 18 of 30 Providers Reviewed A-01-18-02505

Updated: Corporate Integrity Agreements

08-20-2020

Updated: Fraud Risk Indicator

New Jersey Did Not Ensure That Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries Residing in Nursing Facilities Were Always Properly Investigated and Reported  A-02-18-01006

08-18-2020

Nebraska Claimed Unallowable School-Based Administrative Costs Because of Improper Coding of Random Moment Timestudy Responses A-07-19-03234

Medicare Home Health Agency Provider Compliance Audit: Mission Home Health of San Diego, Inc.  A-09-18-03008

08-17-2020

Updated: Work Plan

Opioid Use in Medicare Part D Continued To Decline in 2019, but Vigilance Is Needed as COVID-19 Raises New Concerns OEI-02-20-00320

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2018 Average Sales Prices OEI-03-20-00130

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2020 OEI-03-20-00060

08-14-2020

Medicare Laboratory Test Expenditures Increased in 2018, Despite New Rate Reductions  (OEI-09-19-00100)

08-12-2020

Visionquest Industries, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03010

Medicare Home Health Agency Provider Compliance Audit: Condado Home Care Program, Inc. A-02-17-01022

08-11-2020

OIG's Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs

08-10-2020

Desoto Home Health Care, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03021

08-07-2020

Inadequate Edits and Oversight Caused Medicare To Overpay More Than $267 Million for Hospital Inpatient Claims With Post-Acute-Care Transfers to Home Health Services A-04-18-04067

08-06-2020

LEIE Database Updated with July 2020 Exclusions and Reinstatements

Some Nursing Homes' Reported Staffing Levels in 2018 Raise Concerns; Consumer Transparency Could Be Increased OEI-04-18-00450

Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2019 A-18-20-11300

Updated: Corporate Integrity Agreements

08-05-2020

Updated: Provider Self-Disclosure Settlements

Updated: Corporate Integrity Agreements

08-04-2020

Updated COVID-19 FAQs

08-03-2020

Emergency Response Toolkits: Key Insights and Lessons Learned

July

07-31-2020

North Carolina Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse and Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Timely A-04-17-04063

07-30-2020

Kansas Did Not Ensure That Group Homes for Children in Foster Care Complied With All State Health and Safety Requirements A-07-19-06087

Factsheet: Ohio's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-05-19-00036

UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency

07-29-2020

The New York State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-04-19-06223

07-28-2020

New Jersey's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 9 of 30 Providers Reviewed A-02-19-02004

07-27-2020

Updated: Work Plan

Updated Corporate Integrity Agreements

07-24-2020

Utah's Monitoring Process Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements A-07-19-06085

On-Site Psychological Services, P.C.: Audit of Medicare Payments for Psychotherapy Services A-02-19-01012

Alaska Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-09-19-02001

Advisory Opinion 20-04 (regarding a charitable organization's proposal to purchase or receive donations of unpaid medical debt owed by qualifying patients from certain types of health care providers and then forgive that debt)

Updated Corporate Integrity Agreements

07-23-2020

CMS Could Have Saved $192 Million by Targeting Home Health Claims for Review With Visits Slightly Above the Threshold That Triggers a Higher Medicare Payment A-09-18-03031

HRSA's Monitoring Did Not Always Ensure Health Centers' Compliance With Federal Requirements for HRSA's Access Increases In Mental Health and Substance Abuse Services Supplemental Grant Funding A-02-18-02010

07-22-2020

FY 2019 Health Care Fraud and Abuse Control Program Report

07-16-2020

CMS Did Not Administer and Manage Strategic Communications Services Contracts in Accordance With Federal Requirements A-12-19-20003

Ohio Did Not Ensure the Accuracy and Completeness of Psychotropic and Opioid Medication Information Recorded in Its Child Welfare Information System for Children in Foster Care A-05-18-00007

07-15-2020

Updated: Work Plan

Hospitals Overbilled Medicare $1 Billion by Incorrectly Assigning Severe Malnutrition Diagnosis Codes to Inpatient Hospital Claims A-03-17-00010

Updated Corporate Integrity Agreements

07-14-2020

Medicaid Data Can Be Used To Identify Instances of Potential Child Abuse or Neglect  A-01-19-00001

07-13-2020

Texas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-04003

Updated Corporate Integrity Agreements

07-10-2020

LEIE Database Updated with June 2020 Exclusions and Reinstatements

Sharon Baptist Head Start Claimed Unallowable Rent and Failed To Return Embezzled Funds A-02-17-02003

07-09-2020

Updated Corporate Integrity Agreements

07-08-2020

Freedom Orthotics, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03012

Loophole in Drug Payment Rule Continues To Cost Medicare and Beneficiaries Hundreds of Millions of Dollars OEI-BL-20-00100

Updated: Fraud Risk Indicator

Updated: Provider Self-Disclosure Settlements

07-07-2020

2019 Performance Data for the Senior Medicare Patrol Projects OEI-02-20-00150

Updated Corporate Integrity Agreements

07-02-2020

Updated Corporate Integrity Agreements

Updated: Work Plan

07-01-2020

Advisory Opinion 20-03 (regarding an arrangement under which a discount medical plan organization ("DMPO") pays chiropractors and chiropractic clinics a fee for each new DMPO member referred by the chiropractor or chiropractic clinic)

June

06-30-2020

Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2020 OEI-05-20-00190

06-26-2020

Hawaii Medicaid Fraud Control Unit: 2019 Onsite Review OEI-06-19-00110

Updated: Fraud Risk Indicator

06-23-2020

Updated: Work Plan

06-19-2020

Updated Corporate Integrity Agreements

06-18-2020

Unaccompanied Alien Children Program Care Provider Facilities Do Not Include All Required Security Measures in Their Checklists OEI-05-19-00210

The Office of Refugee Resettlement's Incident Reporting System Is Not Effectively Capturing Data To Assist Its Efforts To Ensure the Safety of Minors in HHS Custody OEI-09-18-00430

Press Release: HHS-OIG: Significant Incidents Involving Unaccompanied Children Not Effectively Captured in Reporting System; Facility Physical Security Inspection Checklists Need Improvement

View a timeline detailing OIG's national review of the UAC Program

06-15-2020

Updated Stipulated Penalties and Exclusion for Material Breach

Updated: Work Plan

06-10-2020

LEIE Database Updated with May 2020 Exclusions and Reinstatements

Updated Provider Self-Disclosure Settlements

06-09-2020

Updated Corporate Integrity Agreements

06-08-2020

Texas Telemedicine Services Were Provided in Accordance with State Requirements A-06-18-05001

Medicare Hospital Provider Compliance Audit: The Ohio State University Hospital A-05-18-00042

06-05-2020

HHS Should Address Gaps in Incident Response Capabilities Across the Department A-18-17-04002

06-04-2020

Updated Corporate Integrity Agreements

06-03-2020

The National Cancer Institute Needs To Strengthen Procedures in Its Pre-Award Process To Assess Risk for Higher Risk Applicants A-03-19-03004

New Jersey Did Not Ensure That Its Managed Care Organizations Adequately Assessed and Covered Medicaid Beneficiaries' Needs for Long-Term Services and Supports A-02-17-01018

06-01-2020

Spring 2020 Semiannual Report to Congress

May

05-28-2020

Updated Corporate Integrity Agreements

05-27-2020

The National Eye Institute Generally Had Adequate Procedures To Assess an Applicant's Risk During the Pre-Award Process A-05-19-00017

05-26-2020

COVID-19 Response Strategic Plan

Opening Statement for Christi Grimm, Principal Deputy Inspector General, Office of Inspector General, U.S. House Committee on Oversight and Reform: Oversight Related to Coronavirus Response Efforts

05-22-2020

Updated: Work Plan

Updated Corporate Integrity Agreements

05-14-2020

UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency

05-13-2020

Updated Corporate Integrity Agreements

05-12-2020

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 2019 A-17-20-52000

05-08-2020

LEIE Database Updated with April 2020 Exclusions and Reinstatements

UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency

HHS Operating Division Needs to Improve Security Controls to More Effectively Prevent Cyberattacks A-18-18-08400

05-07-2020

HHS OIG Toolkits for Calculating Opioid Levels and Identifying Patients At Risk of Misuse or Overdose

Medicare Part D Beneficiaries at Serious Risk of Opioid Misuse or Overdose: A Closer Look OEI-02-19-00130

Updated Provider Self-Disclosure Settlements

05-06-2020

Updated Corporate Integrity Agreements

05-05-2020

Illinois' Monitoring Did Not Ensure Childcare Provider Compliance With State Criminal Background Check Requirements at 12 of 30 Providers Reviewed A-05-19-00016

Medicare Made $11.7 Million in Overpayments for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays A-01-17-00508

05-04-2020

Selected Health Care Coalitions Increased Involvement in Whole Community Preparedness But Face Developmental Challenges Following New Requirements in 2017 OEI-04-18-00080

05-01-2020

North Carolina Received $30 Million in Excess Federal Funds Related to Improperly Claimed Health Home Expenditures A-04-18-00120

UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency

April

04-30-2020

Updated Corporate Integrity Agreements

Updated Civil Monetary Penalties and Affirmative Exclusions

04-28-2020

Updated: Work Plan

04-24-2020

UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency

04-23-2020

UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency

04-22-2020

Grand Desert Psychiatric Services: Audit of Medicare Payments for Psychotherapy Services A-09-19-03018

Recommendation Followup: Michigan Did Not Report and Refund the Full Federal Share of Medicaid Overpayments A-05-18-00022

04-21-2020

Grants, Contracts, and Other Agreements: Fraud and Abuse; Information Blocking; Office of Inspector General's Civil Money Penalty Rules

• Press Release: OIG proposes rule for civil money penalties for 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 Emergency

Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs A-07-20-00589

Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Pension Costs A-07-20-00588

Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00587

Palmetto Government Benefits Administrator, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00586

HHS Operating Division Needs to Improve Information Technology Continuity Planning A-18-18-04005

04-20-2020

Cape Cod Child Development Program Did Not Meet Its Head Start Non-Federal Share Obligations A-01-19-02500

Updated Corporate Integrity Agreements

04-17-2020

Updated Corporate Integrity Agreements

04-15-2020

Mississippi Needs To Improve Oversight of Its Child Care Payment Program A-07-18-04111

96 Percent of South Carolina's Medicaid Fee-for-Service Telemedicine Payments Were Insufficiently Documented or Otherwise Unallowable A-04-18-00122

Updated Corporate Integrity Agreements

Updated: Work Plan

04-14-2020

Medicare Home Health Agency Provider Compliance Audit: Residential Home Health A-05-16-00063

Updated Corporate Integrity Agreements

04-13-2020

An Estimated 87 Percent of Inpatient Psychiatric Facility Claims With Outlier Payments Did Not Meet Medicare's Medical Necessity or Documentation Requirements A-01-16-00508

Most Indian Health Service Purchased/Referred Care Program Claims Were Not Reviewed, Approved, and Paid in Accordance With Federal Requirements 

04-10-2020

LEIE Database Updated with March 2020 Exclusions and Reinstatements

04-09-2020

New York Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-02-18-01016

Iowa Inadequately Monitored Its Medicaid Health Home Providers, Resulting in Tens of Millions in Improperly Claimed Reimbursement A-07-18-04109

Updated Fraud Risk Indicator

04-07-2020

Updated Corporate Integrity Agreements

Updated Provider Self-Disclosure Settlements

Updated CIA Reportable Events

Updated: Work Plan

04-06-2020

Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020 OEI-06-20-00300

The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2018 in Accordance With Federal Requirements A-04-19-04072

Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2019 A-18-19-11200

New Hampshire's Monitoring Did Not Ensure Childcare Provider Compliance With State Criminal Background Check Requirements at 21 of 30 Providers Reviewed A-01-18-02504

04-03-2020

OIG Policy Statement Regarding Application of Certain Administrative Enforcement Authorities Due to Declaration of Coronavirus Disease 2019 (COVID-19) Outbreak in the United States as a National Emergency

FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency

NIH Has Acted To Protect Confidential Information Handled by Peer Reviewers, But It Could Do More OEI-05-19-00240

04-01-2020

States Could Do More To Prevent Terminated Providers From Serving Medicaid Beneficiaries OEI-03-19-00070

Twenty-Three States Reported Allowing Unenrolled Providers To Serve Medicaid Beneficiaries OEI-05-19-00060

March

03-31-2020

New York's Oversight of Medicaid Managed Care Organizations Did Not Ensure Providers Complied With Health and Safety Requirements at 18 of 20 Adult Day Care Facilities Reviewed A-02-18-01027

Medicare Hospital Provider Compliance Audit: Forbes Hospital A-03-18-00005

Updated Civil Monetary Penalties and Affirmative Exclusions

Updated CIA Reportable Events

03-30-2020

OIG Strategic Plan 2020–2025

Message from leadership on minimizing burdens on providers

Iowa Did Not Comply With Federal and State Requirements for Major Incidents Involving Medicaid Members With Developmental Disabilities A-07-18-06081

03-27-2020

At A Glance: Medicaid Fraud Control Units Fiscal Year 2019 Annual Report

Medicare Dialysis Services Provider Compliance Review: Bio-Medical Applications of Arecibo, Inc. A-02-17-01016

Risk Assessment of HHS Grant Closeout Procedures A-04-19-08072

Updated Corporate Integrity Agreements

03-26-2020

Most of the Non-Newly Eligible Beneficiaries for Whom Colorado Made Medicaid Payments Met Federal and State Requirements, but Documentation Supporting That All Eligibility Requirements Were Verified Properly Was Not Always in Place A-07-18-02812

Office of Counsel inquiries should be directed to officeofcounsel@oig.hhs.gov

03-24-2020

FAQ: Waiving Telehealth Cost-Sharing During COVID-19 Outbreak

Florida Made Almost $4 Million in Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid ID Numbers A-04-18-07080

Updated Corporate Integrity Agreements

03-23-2020

Fraud Alert: COVID-19 Scams

Montana Medicaid Fraud Control Unit: 2019 Onsite Inspection OEI-12-19-00170

Updated: Work Plan

03-20-2020

Updated Corporate Integrity Agreements

03-19-2020

CMS Could Take Actions To Help States Comply With Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions  A-09-18-02004

03-18-2020

States' Use of Grant Funding for a Targeted Response to the Opioid Crisis OEI-BL-18-00460

03-17-2020

Waiving Telehealth Cost-Sharing During COVID-19 Outbreak

• Telehealth Factsheet
• Telehealth Frequently Asked Questions

Missouri Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-07-18-03230

03-16-2020

The National Institutes of Health Has Controls to Mitigate the Risk That Grantees Receive Duplicate Grant Funding A-02-19-02002

Updated Corporate Integrity Agreements

Updated Civil Monetary Penalties and Affirmative Exclusions

Updated: Work Plan

03-11-2020

Updated Corporate Integrity Agreements

03-10-2020

LEIE Database Updated with February 2020 Exclusions and Reinstatements

Factsheet: Kentucky's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-04-19-02022

SAMHSA's Oversight of Accreditation Bodies for Opioid Treatment Programs Did Not Comply With Some Federal Requirements A-09-18-01007

Key Medicare Tools To Safeguard Against Pharmacy Fraud and Inappropriate Billing Do Not Apply to Part D OEI-02-15-00440

Florida Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-18-08065

03-09-2020

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2019 OEI-03-20-00040

03-05-2020

Communication and Management Challenges Impeded HHS's Response to the Zero-Tolerance Policy OEI-BL-18-00510

Press Release: HHS OIG: Communication and Management Challenges Impeded HHS's Response to Zero-Tolerance Policy

03-04-2020

Medicare Hospital Provider Compliance Audit: Saint Francis Health Center A-07-17-05102

Updated Provider Self-Disclosure Settlements

03-03-2020

New Mexico's Monitoring of Childcare Providers Generally Ensured Provider Compliance With State Criminal Background Check Requirements at 30 Childcare Providers Reviewed A-06-19-07001

The Centers for Medicare & Medicaid Services Did Not Identify and Report Potential Antideficiency Act Violations for 12 Contracts Used To Establish the Federal Marketplace Under the Affordable Care Act A-03-16-03001

Updated Corporate Integrity Agreements

03-02-2020

CHI St. Vincent Infirmary: Audit of Outpatient Outlier Payments A-06-16-01002

National Institutes of Health Had Information Technology Control Weaknesses Surrounding Its Electronic Health Record System A-18-19-06003

February

02-27-2020

Testimony of Suzanne Murrin, Deputy Inspector General, Office of Evaluation and Inspections, Office of Inspector General, U.S. House Committee on Appropriations, Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies: Oversight of the Food and Drug Administration

02-26-2020

Ownership—But Not Physical Movement—of Selected Drugs Can Be Traced Through the Supply Chain OEI-05-17-00460

New York Made Unallowable Payments Totaling More Than $10 Million for Managed Care Beneficiaries Assigned Multiple Medicaid Identification Numbers A-02-18-01020

New York Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-02-18-01011

02-24-2020

OCIG Job Posting: Senior Counsel for Exclusions
(Washington, DC) - Deadline 02/28/2020

02-21-2020

Updated Corporate Integrity Agreements

02-20-2020

Michigan Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-05-17-00048

02-18-2020

Opportunities for Williamson and Burnet Counties Had Ineffective Accounting Controls and Used Unapproved or Questionable Cost Allocation Methods A-06-18-02002

Updated: Work Plan

02-14-2020

The Majority of Providers Reviewed Used Medicare Part D Eligibility Verification Transactions for Potentially Inappropriate Purposes A-05-17-00020

Georgia's Monitoring of Childcare Providers Ensured Provider Compliance With State Criminal Background Check Requirements A-04-19-03580

02-13-2020

The Indiana State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-05-19-00007

Wateree Community Actions, Inc., Made Improvements but Still Requires Monitoring A-04-19-08069

New York Followed Its Approved Methodology for Claiming Enhanced Medicaid Reimbursement Under the Community First Choice Option A-02-17-01015

02-12-2020

The Federal Marketplace Properly Determined Individuals' Eligibility for Enrollment in Qualified Health Plans but Improperly Determined That an Estimated 3 Percent of Individuals Were Eligible for Insurance Affordability Programs A-09-18-01000

02-10-2020

FY 2021 Congressional Budget Justification

LEIE Database Updated with January 2020 Exclusions and Reinstatements

Life Safety and Emergency Preparedness Deficiencies Found at 18 of 20 Texas Nursing Homes A-06-19-08001

Job Opening: Associate Counsel for Exclusions (Washington, DC)

02-06-2020

New York Claimed Tens of Millions of Dollars for Opioid Treatment Program Services That Did Not Comply With Medicaid Requirements Intended To Ensure the Quality of Care Provided to Beneficiaries A-02-17-01021

Updated Provider Self-Disclosure Settlements

02-04-2020

Missouri Medicaid Fraud Control Unit: 2018 Onsite Inspection OEI-12-18-00490

02-03-2020

Geographic Disparities Affect Access to Buprenorphine Services for Opioid Use Disorder OEI-12-17-00240

January

01-30-2020

More Than One-Third of New Jersey's Federal Medicaid Reimbursement for Providing Community-Based Treatment Services Was Unallowable A-02-17-01020

01-29-2020

Medicare Market Shares of Diabetes Test Strips From April Through June 2019  OEI-04-19-00481

01-27-2020

The National Institutes of Health Submitted OIG Clearance Documents for Just Over One-Half of Its Audit Recommendations, and the Remaining 225 Recommendations Were Unresolved as of September 30, 2016 A-07-19-03236

CMS's Implementation of a 2014 Policy Change Resulted in Improvements in the Reporting of Coverage Gap Discounts Under Medicare Part D A-07-16-06067

Tennessee's Monitoring Ensured Compliance With Criminal Background Check Requirements at 28 of the 30 Childcare Providers Reviewed A-04-19-02023

01-24-2020

Advisory Opinion 20-02 (regarding financial assistance for travel, lodging, and other expenses provided by a pharmaceutical manufacturer to certain patients prescribed the manufacturer's drug)

01-23-2020

Updated Corporate Integrity Agreements

01-22-2020

Pennsylvania Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-03-17-00202

Updated Corporate Integrity Agreements

Updated Civil Monetary Penalties and Affirmative Exclusions

01-17-2020

Florida's Refugee Medical Assistance Payments Were Generally Allowable A-04-18-02010

Novitas Solutions, Inc. Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances  A-06-17-04002

Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings A-04-19-06232

01-16-2020

CMS's Controls Over Assigning Medicare Beneficiary Identifiers and Mailing New Medicare Cards Were Generally Effective but Could Be Improved in Some Areas A-09-19-03003

01-15-2020

Updated Corporate Integrity Agreements

Updated: Work Plan

01-14-2020

New York Improperly Claimed Medicaid Reimbursement for Some Bridges to Health Waiver Program Services That Were Not in Accordance With an Approved Plan of Care and Did Not Meet Documentation Requirements A-02-18-01003

01-13-2020

Advisory Opinion 20-01 (regarding a hospital's provision of discounted training to a specified fire department's personnel at the hospital's facility)

01-10-2020

LEIE Database Updated with December 2019 Exclusions and Reinstatements

Updated Provider Self-Disclosure Settlements

01-06-2020

Updated Corporate Integrity Agreements

01-03-2020

Updated Corporate Integrity Agreements

---

2019

December

12-23-2019

Updated Civil Monetary Penalties and Affirmative Exclusions

12-20-2019

Indian Health Service Has Strengthened Patient Protection Policies but Must Fully Integrate Them Into Practice and Organizational Culture OEI-06-19-00330

12-18-2019

Video: Healthcare Fraud: What You Need To Know

12-17-2019

Advisory Opinion 19-06 (regarding a supermarket's proposal to expand its current loyalty program to allow customers to earn rewards points on out-of-pocket costs paid in connection with pharmacy purchases)

12-16-2019

Eye on Oversight: 2019 Year in Review

CMS Made an Estimated $93.6 Million in Incorrect Medicare Electronic Health Record Incentive Payments to Acute-Care Hospitals, or Less Than 1 Percent of $10.8 Billion in Total Incentive Payments A-09-18-03020

California Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program A-09-18-01006

Medicare Home Health Agency Provider Compliance Audit: Palos Community Hospital Home Health Agency A-05-17-00022

Updated: Work Plan

12-13-2019

Medicare Hospital Provider Compliance Audit: Texas Health Presbyterian Hospital Dallas  A-04-18-08068

Updated Civil Monetary Penalties and Affirmative Exclusions

12-12-2019

Billions in Estimated Medicare Advantage Payments From Chart Reviews Raise Concerns OEI-03-17-00470

Updated Corporate Integrity Agreements

12-10-2019

LEIE Database Updated with November 2019 Exclusions and Reinstatements

12-06-2019

Medicare Hospital Provider Compliance Audit: St. Vincent Hospital A-05-18-00040

12-04-2019

Factsheet: Alabama's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-04-19-00125

Pathways for Children Needs To Strengthen Documentation Requirements A-01-18-02503

Updated Corporate Integrity Agreements

12-03-2019

Medicare Hospital Provider Compliance Audit: Northwest Medical Center A-04-18-08064

Medicare Hospital Provider Compliance Audit: Carolinas Hospital A-04-18-08063

12-02-2019

Fall 2019 Semiannual Report to Congress

OIG Fiscal Year 2019 Semiannual Report Reveals Taxpayers Could See Nearly $5.9 Billion Returned to Government

November

11-27-2019

Hospitals Received Millions in Excessive Outlier Payments Because CMS Limits the Reconciliation Process A-05-16-00060

11-26-2019

Noridian Healthcare Solutions, LLC, Did Not Claim Allowable Medicare Nonqualified Costs A-07-19-00574

Noridian Healthcare Solutions, LLC, Did Not Claim Allowable Medicare Nonqualified Costs Through Its Incurred Cost Proposals A-07-19-00573

Updated Civil Monetary Penalties and Affirmative Exclusions

11-25-2019

Cahaba Safeguard Administrators, LLC, Properly Updated the Medicare Segment Pension Assets as of January 1, 2017 A-07-19-00571

Cahaba Government Benefits Administrators, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-19-00570

11-22-2019

Highlands of Little Rock West Markham Holdings, LLC: Audit of Documentation of Therapy Resource Utilization Groups A-06-18-08003

Updated Corporate Integrity Agreements

11-21-2019

Registered Nurses Did Not Always Visit Medicare Beneficiaries' Homes At Least Once Every 14 Days To Assess The Quality of Care and Services Provided by Hospice Aides A-09-18-03022

11-19-2019

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2019 (OEI-03-20-00070)

11-18-2019

2019 Top Management & Performance Challenges Facing HHS

11-15-2019

Updated Corporate Integrity Agreements

Updated: Work Plan

11-14-2019

Eye on Oversight - The New HHS OIG Hotline

Statement for the Record: Office of Inspector General, U.S. Department of Health and Human Services: U.S. House Committee on Ways and Means: Caring for Aging Americans

New Jersey Improperly Claimed Tens of Millions for Medicaid School-Based Administrative Costs Based on Random Moment Sampling That Did Not Meet Federal Requirements A-02-17-01006

California Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-09-18-02009

The University of Minnesota Complied With Federal Requirements To Perform Risk Assessments and Monitor Subrecipients A-05-18-00015

11-12-2019

Medicare Made Hundreds of Thousands of Dollars in Overpayments for Chronic Care Management Services A-07-17-05101

Updated Corporate Integrity Agreements

11-08-2019

Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs A-07-19-00569

Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00568

Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Postretirement Benefit Assets A-07-19-00567

Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-18-00550

Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Pension Costs A-07-18-00548

Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Pension Assets A-07-18-00547

Updated Corporate Integrity Agreements

11-06-2019

Medicare Improperly Paid Acute-Care Hospitals $54.4 Million for Inpatient Claims Subject to the Post-Acute-Care Transfer Policy A-09-19-03007

Updated CIA Reportable Events

Updated Provider Self-Disclosure Settlements

11-05-2019

Audit of Medicare Part D Pharmacy Fees: Geisinger Health Systems, Inc. A-03-18-00006

11-04-2019

LEIE Database Updated with October 2019 Exclusions and Reinstatements

Medicare Allowable Amounts for Certain Orthotic Devices Are Not Comparable With Payments Made by Select Non-Medicare Payers A-05-17-00033

Medicare Improperly Paid Suppliers an Estimated $92.5 Million for Inhalation Drugs A-09-18-03018

Medicare Home Health Agency Provider Compliance Review: Angels Care Home Health A-07-16-05093

October

10-31-2019

Tennessee Made Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid Identification Numbers A-04-18-07079

Texas Did Not Ensure That Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-06-16-01001)

10-30-2019

Testimony of Brian P. Ritchie, Assistant Inspector General for Audit Services, Office of Inspector General, U.S. Department of Health and Human Services: U.S. Senate Committee on Finance, Subcommittee on Health Care: Medicaid: Compliance with Eligibility Requirements

10-28-2019

U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement A-17-19-54000

Rhode Island Hospital Submitted Some Inaccurate Wage Data A-01-17-00509

The Centers for Medicare & Medicaid Services Could Improve Its Processes for Evaluating and Reporting Payment Recovery Savings Associated With the Fraud Prevention System A-01-15-00510

10-25-2019

Updated Corporate Integrity Agreements

10-24-2019

Testimony of Gary Cantrell, Deputy Inspector General for Investigations, Office of Investigations, Office of Inspector General, U.S. Department of Health and Human Services: U.S. Senate Committee on Finance: OIG's Efforts to Address the Prescribing and Treatment Dimensions of the Opioid Crisis

10-23-2019

Sunshine ACO, LLC, Generally Reported Complete and Accurate Data on Quality Measures Through the CMS Web Portal, but There Were a Few Reporting Deficiencies That Did Not Affect the Overall Quality Performance Score (A-09-18-03019)

Updated Civil Monetary Penalties and Affirmative Exclusions

10-22-2019

Trends in Nursing Home Complaints (2016-2018)

10-21-2019

New York State Claimed Federal Reimbursement for Unallowable Childcare Subsidies Paid to New York City (A-02-17-02010)

10-15-2019

Updated Fraud Risk Indicator

Updated: Work Plan

10-10-2019

LEIE Database Updated with September 2019 Exclusions and Reinstatements

Updated CIA Reportable Events

Updated Provider Self-Disclosure Settlements

10-09-2019

Revisions to the Safe Harbors Under the Anti-Kickback Statute and Civil Monetary Penalty Rules Regarding Beneficiary Inducements

• Fact Sheet:
  Notice of Proposed Rulemaking OIG-0936-AA10-P

Wisconsin Physicians Service Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances (A-06-17-04005)

Updated Corporate Integrity Agreements

Updated State False Claims Act Review Letters

10-08-2019

Updated Corporate Integrity Agreements

10-04-2019

The Next Door Foundation Claimed Unallowable Indirect Costs and Did Not Document the Funding Source of Program Expenditures in Accordance With Federal Requirements (A-05-18-00008)

10-03-2019

The Minnesota State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths (A-05-17-00049)

Updated Stipulated Penalties and Exclusion for Material Breach

Updated Civil Monetary Penalties and Affirmative Exclusions

10-02-2019

California Needs To Improve Oversight of Community-Based Adult Services Providers' Compliance With Health and Safety and Administrative Requirements (A-09-18-02002)

10-01-2019

National Government Services, Inc., Did Not Claim Some Medicare Postretirement Benefit Plan Costs Through Its Incurred Cost Proposals (A-07-19-00566)

National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals  (A-07-19-00572)

Updated Corporate Integrity Agreements

Spring and Summer Internship Applications

September

09-30-2019

National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals (A-07-19-00564)

National Government Services, Inc., Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals (A-07-19-00565)

09-27-2019

Nationwide Genetic Testing Fraud

NIH Has Made Strides in Reviewing Financial Conflicts of Interest in Extramural Research, But Could Do More (OEI-03-19-00150)

Vetting Peer Reviewers at NIH's Center for Scientific Review: Strengths and Limitations (OEI-01-19-00160)

Patient Safety Organizations: Hospital Participation, Value, and Challenges (OEI-01-17-00420)

The National Institutes of Health Has Limited Policies, Procedures, and Controls in Place for Helping To Ensure That Institutions Report All Sources of Research Support, Financial Interests, and Affiliations (A-03-19-03003)

Updated Corporate Integrity Agreements

09-26-2019

Department of Health and Human Services Had Email Requirements for Political Appointees, but Office of the Secretary Lacked Effective Monitoring and Enforcement  (A-18-18-11050)

The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2017 in Accordance With Federal Requirements  (A-04-19-04071)

National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Final Administrative Cost Proposals (A-07-19-00563)

National Government Services, Inc., Claimed Some Unallowable Supplemental Executive Retirement Plan Costs Through Its Final Administrative Cost Proposals (A-07-18-00551)

09-24-2019

CMS Paid Over $277 Million in Unallowable CHIPRA Bonus Payments Based on Incorrect Enrollment Data (A-04-17-08061)

09-23-2019

Ohio Made Medicaid Capitation Payments That Were Duplicative or Were Improper Based on Beneficiary Eligibility Status or Demographics (A-05-16-00061)

Opioid Use in Medicare Part D in Missouri (OEI-02-19-00391)

Arrested Deadbeat: Charles Hefner

09-20-2019

Reasonable Assumptions in Manufacturer Reporting of AMPs and Best Prices (OEI-12-17-00130)

09-19-2019

Testimony of Ann Maxwell, Assistant Inspector General, Office of Inspector General, Office of Evaluation and Inspections, U.S. Department of Health and Human Services: U.S. House Committee on Energy & Commerce: HHS-OIG Oversight of the Unaccompanied Alien Children Program

Some Medicare Part D Beneficiaries Face Avoidable Extra Steps That Can Delay or Prevent Access to Prescribed Drugs (OEI-09-16-00411)

Texas Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-06-17-04001)

09-18-2019

Testimony of Ann Maxwell, Assistant Inspector General, Office of Inspector General, Office of Evaluation and Inspections, U.S. Department of Health and Human Services: U.S. House Committee on Appropriations: HHS-OIG Oversight of the Unaccompanied Alien Children Program

Medicare's Oversight of Ambulatory Surgery Centers (OEI-01-15-00400)

Updated Civil Monetary Penalties and Affirmative Exclusions

Updated Stipulated Penalties and Exclusion for Material Breach

Updated CIA Reportable Events

09-16-2019

Provider Shortages and Limited Availability of Behavioral Health Services in New Mexico's Medicaid Managed Care (OEI-02-17-00490)

Medicare Incorrectly Paid Providers for Emergency Ambulance Transports From Hospitals to Skilled Nursing Facilities (A-09-18-03030)

Updated: Work Plan

09-13-2019

Rebates for Brand Name Drugs in Part D Substantially Reduced the Growth in Spending from 2011 to 2015 (OEI-03-19-00010)

Updated Provider Self-Disclosure Settlements

Updated Grantee Self-Disclosure Protocol

09-12-2019

Vermont's Office of Child Support Needs Better Oversight Over Its Administrative Costs Claimed (A-01-18-02501)

09-11-2019

Advisory Opinion 19-05 (regarding a proposed purchase of real estate from a limited liability company owned, in part, by an excluded individual)

09-10-2019

The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home Health Agencies  (A-05-17-00035)

Advisory Opinion 19-04 (regarding a technology company's proposal to make visible to Federal health care program beneficiaries: (i) its online healthcare directory for searching and booking medical appointments, where healthcare professionals pay, or would pay, per-click or per-booking fees to be listed in the directory; and (ii) sponsored advertisements on its online healthcare directory and third-party websites, where healthcare professionals pay, or would pay, per-impression or per-click fees for such sponsored advertisements (the "Proposed Arrangement"))

09-06-2019

LEIE Database Updated with August 2019 Exclusions and Reinstatements

09-05-2019

Twin Palms Received Unallowable Medicare Payments for Chiropractic Services (A-04-16-07065)

West Florida ACO, LLC, Generally Reported Complete and Accurate Data on Quality Measures Through the CMS Web Portal, but There Were a Few Reporting Deficiencies That Did Not Affect the Overall Quality Performance Score (A-09-18-03003)

Oceanside Medical Group Received Unallowable Medicare Payments for Psychotherapy Services (A-09-18-03004)

Updated Corporate Integrity Agreements

09-04-2019

Care Provider Facilities Described Challenges Addressing Mental Health Needs of Children in HHS Custody (OEI-09-18-00431)

Unaccompanied Alien Children Care Provider Facilities Generally Conducted Required Background Checks but Faced Challenges in Hiring, Screening, and Retaining Employees (A-12-19-20001)

Featured Topics: Unaccompanied Children

Media Materials: Unaccompanied Children

Colorado Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries (A-07-16-04228)

Florida Medicaid Paid Hundreds of Millions in Unallowable Payments to Jackson Memorial Hospital Under Its Low Income Pool Program (A-04-17-04058)

09-03-2019

New Jersey Did Not Bill Manufacturers for Tens of Millions of Dollars in Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-02-16-01011)

Illinois Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries' Deaths (A-05-18-00026)

August

08-29-2019

Organizational Challenges to Improving Quality of Care in Indian Health Service Hospitals (OEI-06-16-00390)

Mederi Caretenders Home Health Billed for Home Health Services That Did Not Comply With Medicare Billing Requirements (A-07-16-05092)

08-28-2019

Utah Medicaid Fraud Control Unit: 2018 Onsite Review (OEI-09-18-00170)

All Six States Reviewed Had Partially Implemented New Criminal Background Check Requirements for Childcare Providers, and Five of the States Anticipate Full Implementation by Fiscal Year 2020 (A-05-19-00015)

08-27-2019

Medicare Part D Is Still Paying Millions for Drugs Already Paid for Under the Part A Hospice Benefit (A-06-17-08004)

Updated Civil Monetary Penalties and Affirmative Exclusions

08-26-2019

National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded in 2017 and 2018 (OEI-07-18-00290)

08-23-2019

New York Incorrectly Claimed Enhanced Federal Medicaid Reimbursement for Some Beneficiaries (A-02-15-01023)

New York Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness (A-02-17-01027)

The Administration for Children and Families Should Improve the Oversight of Tribal Grantees' Low-Income Home Energy Assistance Programs (A-07-17-04105)

Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2018 (A-18-19-11300)

08-22-2019

Idaho Medicaid Fraud Control Unit: 2018 Onsite Inspection (OEI-12-18-00320)

The Food and Drug Administration Did Not Submit Clearance Documents for Any Audit Recommendations During Fiscal Years 2015 and 2016 but Has Since Made Significant Progress (A-07-18-03231)

08-20-2019

National Review of Opioid Prescribing in Medicaid Is Not Yet Possible (OEI-05-18-00480)

Southwest Key Did Not Have Adequate Controls in Place To Secure Personally Identifiable Information Under the Unaccompanied Alien Children Program (A-18-18-06001)

Southwest Key Programs Did Not Always Comply With Health and Safety Requirements For The Unaccompanied Alien Children Program (A-06-17-07005)

Connecticut Claimed Unallowable Federal Reimbursement for Medicaid Physician-Administered Drugs That Were Not Invoiced to Manufacturers for Rebates (A-07-18-06078)

The Health Resources and Services Administration Resolved All of Its Audit Recommendations, With Over 99 Percent Resolved in Accordance With Federal Timeliness Requirements (A-07-19-03235)

08-19-2019

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2017 Average Sales Prices (OEI-03-19-00260)

08-16-2019

Updated Civil Monetary Penalties and Affirmative Exclusions

08-15-2019

Updated: Work Plan

Many Medicaid-Enrolled Children Who Were Treated for ADHD Did Not Receive Recommended Followup Care (OEI-07-17-00170)

HHS Did Not Always Efficiently Plan and Coordinate Its International Ebola Response Efforts (A-04-16-03567)

Pennsylvania Did Not Ensure That Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-03-16-00205)

08-14-2019

The Administration for Community Living Failed To Conduct Any of the Required Onsite Compliance Reviews of Independent Living Programs (A-05-18-00034)

08-13-2019

States' Payment Rates Under the Child Care and Development Fund Program Could Limit Access to Child Care Providers (OEI-03-15-00170)

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2019 (OEI-03-19-00050)

Georgia Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries' Deaths (A-04-15-06183)

New York Achieved Program Goals For Enhancing Its Prescription Drug Monitoring Program (A-02-18-02001)

08-09-2019

Updated Corporate Integrity Agreements

Updated Provider Self-Disclosure Settlements

08-08-2019

LEIE Database Updated with July 2019 Exclusions and Reinstatements

08-06-2019

Updated Corporate Integrity Agreements

July

07-31-2019

Group Health Incorporated Understated Its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets as of January 1, 2015 (A-07-19-00561)

Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Pension Assets as of January 1, 2015  (A-07-19-00562)

Group Health Incorporated Understated Its Cash Balance Pension Plan Medicare Segment Pension Assets as of January 1, 2011 (A-07-19-00557)

07-30-2019

Updated Civil Monetary Penalties and Affirmative Exclusions

07-29-2019

Updated Corporate Integrity Agreements

Updated Stipulated Penalties and Exclusion for Material Breach

07-26-2019

Oversight of Opioid Prescribing and Monitoring of Opioid Use: States Have Taken Action To Address the Opioid Epidemic (A-09-18-01005)

Kansas Medicaid Fraud Control Unit: 2018 Onsite Inspection (OEI-12-18-00210)

07-24-2019

The Substance Abuse and Mental Health Services Administration Resolved Approximately One-Third of Its Audit Recommendations, None in Accordance With Federal Timeframe Requirements (A-07-19-03233)

ACOs' Strategies for Transitioning to Value-Based Care: Lessons From the Medicare Shared Savings Program (OEI-02-15-00451)

07-23-2019

Testimony of Megan H. Tinker, Senior Advisor for Legal Affairs, Office of Counsel to the Inspector General, Office of Inspector General, U.S. Department of Health and Human Services: United States Senate Committee on Finance: Promoting Elder Justice: A Call for Reform

A Resource Guide for Using Diagnosis Codes in Health Insurance Claims To Help Identify Unreported Abuse or Neglect (A-01-19-00502)

07-22-2019

Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG's Top Recommendations

Case Study: Indian Health Service Management of Rosebud Hospital Emergency Department Closure and Reopening (OEI-06-17-00270)

IHS Needs To Improve Oversight of Its Hospitals' Opioid Prescribing and Dispensing Practices and Consider Centralizing Its Information Technology Functions (A-18-17-11400)

New York Did Not Correctly Determine Medicaid Eligibility for Some Non-Newly Eligible Beneficiaries (A-02-16-01005)

07-19-2019

Updated Corporate Integrity Agreements

07-16-2019

99 of 100 California Department of Social Services Refugee Cash Assistance Payments Received Were Allowable (A-04-18-02017)

Kentucky Did Not Comply With Federal Waiver and State Requirements at 14 of 20 Adult Day Health Care Facilities Reviewed  (A-04-18-00123)

Updated Corporate Integrity Agreements

07-15-2019

Problems Remain for Ensuring That All High Risk Medicaid Providers Undergo Criminal Background Checks (OEI-05-18-00070)

Eye on Oversight: Medicaid Provider Enrollment Screening

Updated: Work Plan

07-12-2019

Testimony of Ann Maxwell, Assistant Inspector General, Office of Inspector General, Office of Evaluation and Inspections, Office of Inspector General, U.S. Department of Health and Human Services: U.S. House Committee on Oversight and Reform: HHS-OIG Oversight of the Unaccompanied Alien Children Program

Updated Civil Monetary Penalties and Affirmative Exclusions

07-11-2019

Updated Corporate Integrity Agreements

HHS OIG Grant Self-Disclosure Program Guidance

Updated Grantee Self-Disclosure Protocol

07-10-2019

LEIE Database Updated with June 2019 Exclusions and Reinstatements

Opioid Use Decreased in Medicare Part D, While Medication-Assisted Treatment Increased (OEI-02-19-00390)

New York's Claims for Medicaid Nursing Home Transition and Diversion Waiver Program Services Generally Complied With Federal and State Requirements but Had Reimbursement Errors That Resulted in a Minimal Amount of Overpayments (A-02-17-01005)

New York Claimed Federal Reimbursement for Some Payments to Health Home Providers That Did Not Meet Medicaid Requirements (A-02-17-01004)

Updated Stipulated Penalties and Exclusion for Material Breach

Updated Corporate Integrity Agreements

07-09-2019

Hospice Deficiencies Pose Risks to Medicare Beneficiaries (OEI-02-17-00020)

Safeguards Must Be Strengthened To Protect Medicare Hospice Beneficiaries From Harm (OEI-02-17-00021)

2019: Vulnerabilities in Hospice Care

07-05-2019

Medicare Part D Rebates for Prescriptions Filled at 340B Contract Pharmacies (A-03-16-00002)

Updated Fraud Risk Indicator

07-03-2019

Updated Provider Self-Disclosure Settlements

07-02-2019

Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2019 (OEI-05-19-00220)

The Food and Drug Administration Generally Complied With Federal Requirements for the Preparation and Receipt of Select Agent Shipments (A-03-16-00354)

Recommendation Followup: Delaware Is Reporting Medicaid Overpayments In Compliance With Federal Requirements (A-03-17-00203)

Updated Civil Monetary Penalties and Affirmative Exclusions

07-01-2019

The Florida Department of Children and Families Made Some Unallowable Refugee Cash Assistance Payments (A-04-18-02011)

Updated Civil Monetary Penalties and Affirmative Exclusions

June

06-28-2019

Illinois Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-18-00030)

Updated Corporate Integrity Agreements

06-21-2019

The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2016 in Accordance With Federal Requirements (A-04-18-04065)

Updated Corporate Integrity Agreements

06-20-2019

Updated Corporate Integrity Agreements

06-19-2019

Testimony of Vicki L. Robinson, Senior Counselor for Policy, Office of Inspector General, U.S. Department of Health and Human Services: U.S. Senate Special Committee on Aging: The Complex Web of Prescription Drug Prices, Part III: Examining Agency Efforts to Further Competition and Increase Affordability

Medicare Could Have Saved Millions of Dollars in Payments for Three-Dimensional Conformal Radiation Therapy Planning Services (A-09-18-03026)

06-18-2019

Updated Corporate Integrity Agreements

06-17-2019

Updated: Work Plan

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

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)

---

2018

December

12-27-2018

First Coast Service Options, Inc., Paid Providers for Hyperbaric Oxygen Therapy Services That Did Not Comply With Medicare Requirements (A-04-16-06196)

Updated Civil Monetary Penalties and Affirmative Exclusions

12-21-2018

Midwood Ambulance & Oxygen Service, Inc., Billed for Nonemergency Ambulance Transport Services That Did Not Comply With Medicare Requirements (A-02-16-01021)

Louisiana Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-06-16-02003)

12-20-2018

The Administration for Children and Families Has Controls and Strategies To Mitigate Hurricane Preparedness and Response Risk (A-04-18-02013)

Wisconsin Did Not Report and Refund the Full Federal Share of Medicaid-Related Settlements and a Judgment (A-05-17-00041)

The Health Resources and Services Administration Has Controls and Strategies To Mitigate Hurricane Preparedness and Response Risk (A-04-18-02015)

12-19-2018

Updated Corporate Integrity Agreement List

12-17-2018

Eye on Oversight: 2018 Year in Review

Updated: Work Plan

Factsheet: Washington State's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-09-18-02001)

Texas Claimed Community First Choice Fee-for-Service Expenditures Appropriately (A-06-17-08002)

Payments Made by National Government Services, Inc., to Hospitals for Certain Advanced Radiation Therapy Services Did Not Fully Comply With Medicare Requirements (A-02-16-01007)

12-13-2018

California Made Medicaid Payments on Behalf of Non-Newly Eligible Beneficiaries Who Did Not Meet Federal and State Requirements (A-09-17-02002)

12-12-2018

The National Institutes of Health Generally Complied With Federal Requirements for the Preparation and Receipt of Select Agent Shipments (A-03-15-00354)

12-11-2018

BCFS Health and Human Services Did Not Always Comply With Federal and State Requirements Related to the Health and Safety of Unaccompanied Alien Children (A-06-17-07007)

Vulnerabilities Exist in State Agencies' Use of Random Moment Sampling To Allocate Costs for Medicaid School-Based Administrative and Health Services Expenditures (A-07-18-04107)

The Centers for Medicare & Medicaid Services Had Not Recovered More Than a Billion Dollars in Medicaid Overpayments Identified by OIG Audits (A-05-17-00013)

12-10-2018

OIG Most Wanted Fugitive: Ashot Sanamian

LEIE Database Updated with November 2018 Exclusions and Reinstatements

Job Opening: Affirmative Litigation Attorney

12-06-2018

The Penobscot Indian Nation Did Not Meet All Federal and Tribal Health and Safety Requirements (A-01-17-01502)

Updated Corporate Integrity Agreement List

Updated Provider Self-Disclosure Settlements

Updated Stipulated Penalties and Exclusion for Material Breach

Updated Civil Monetary Penalties and Affirmative Exclusions

12-04-2018

Adverse Events in Long-Term-Care Hospitals: National Incidence Among Medicare Beneficiaries (OEI-06-14-00530)

Podcast: Adverse Events in Long-Term-Care Hospitals

Medicare Improperly Paid Suppliers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Beneficiaries During Inpatient Stays (A-09-17-03035)

Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2017 (A-18-18-11300)

Corporación Salud Asegurada por Nuestra Organización Solidaria, Inc., a Health Resources and Services Administration Grantee, Generally Complied With Federal Grant Requirements (A-02-17-02004)

November

11-30-2018

Fall 2018 Semiannual Report to Congress

HHS OIG: A Good Investment

CMS's Enhanced Controls Did Not Always Prevent Terminated Drug Utilization in Medicare Part D (A-07-16-06068)

New York May Have Improperly Claimed Medicaid Reimbursement for Certain Dental Services (A-02-16-01020)

11-28-2018

Updated Corporate Integrity Agreement List

11-27-2018

The Tornillo Influx Care Facility: Concerns About Staff Background Checks and Number of Clinicians on Staff (A-12-19-20000)

Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Payments (A-01-17-00500)

Summary of Security Vulnerabilities Identified at Two Arizona Managed Care Organizations and Inconsistent Treatment of Medicaid Data Security at the State Agency and Managed Care Organizations (A-18-17-09302)

11-26-2018

Northwestern University Did Not Always Comply With Federal Requirements To Perform Risk Assessments of Subrecipients, but Claimed Allowable Costs (A-05-17-00016)

Updated Corporate Integrity Agreement List

11-20-2018

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2018 (OEI-03-19-00020)

11-16-2018

2018 Top Management and Performance Challenges

Advisory Opinion 18-14 (regarding a drug company's proposal to provide free product to hospitals for the hospitals to use exclusively to treat inpatients who have been diagnosed with one particular condition)

11-15-2018

Updated: Work Plan

National Government Services, Inc., Understated Its Plan A Medicare Segment Pension Assets (A-07-18-00541)

National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs (A-07-18-00543)

National Government Services, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs (A-07-18-00552)

11-14-2018

Payments Made by Novitas Solutions, Inc., to Hospitals for Certain Advanced Radiation Therapy Services Did Not Fully Comply With Medicare Requirements (A-02-16-01006)

Although Hospital Tax Programs in Seven States Complied With Hold-Harmless Requirements, the Tax Burden on Hospitals Was Significantly Mitigated (A-03-16-00202)

11-13-2018

Updated Civil Monetary Penalties and Affirmative Exclusions

11-09-2018

LEIE Database Updated with October 2018 Exclusions and Reinstatements

The Centers for Disease Control and Prevention Has Controls and Strategies To Mitigate Hurricane Preparedness and Response Risk (A-04-18-02014)

Updated: Provider Self-Disclosure Settlements

11-08-2018

Updated Corporate Integrity Agreement List

11-07-2018

Wanted: Oscar Larach-Zablah

11-06-2018

Advisory Opinion 18-13 (regarding proposed donations from a charitable trust and an individual donor to a medical research institute)

Updated Corporate Integrity Agreement List

Providers added to High Risk - Heightened Scrutiny list

11-05-2018

The Centers for Disease Control and Prevention's Namibia Office Implemented Our Prior Audit Recommendations (A-04-18-01008)

CMS Did Not Always Ensure Hospitals Complied With Medicare Reimbursement Requirements for Graduate Medical Education (A-02-17-01017)

New York Claimed Federal Reimbursement for Some Assertive Community Treatment Services That Did Not Meet Medicaid Requirements (A-02-17-01008)

11-01-2018

The Food and Drug Administration's Policies and Procedures Should Better Address Postmarket Cybersecurity Risk to Medical Devices (A-18-16-30530)

October

10-31-2018

Pennsylvania Generally Complied With Maternal, Infant, and Early Childhood Home Visiting Program Requirements (A-03-15-03300)

Updated Stipulated Penalties and Exclusion for Material Breach

10-29-2018

Advisory Opinion 18-12 regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay (the "Proposed Arrangement")

U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Key Areas That Require Improvement (A-17-18-54000)

Professional Clinical Laboratory, Inc., Generally Did Not Comply With Medicare Requirements For Billing Phlebotomy Travel Allowances (A-06-16-02002)

Updated Civil Monetary Penalties and Affirmative Exclusions

10-26-2018

Updated Corporate Integrity Agreement List

10-25-2018

Justice Department's Criminal Division Creates Appalachian Regional Prescription Opioid Strike Force to Focus on Illegal Opioid Prescriptions

Wisconsin Did not Comply With Federal Waiver and State Requirements at all 20 Adult Day Care Centers Reviewed (A-05-17-00030)

10-24-2018

Medicare Compliance Review of Mobile Infirmary Medical Center (A-04-17-08057)

10-19-2018

United Government Services, LLC, Properly Updated the Medicare Segment Pension Assets as of January 1, 2015 (A-07-18-00538)

TrustSolutions, LLC, Properly Updated the Medicare Segment Pension Assets as of December 31, 2012 (A-07-18-00539)

National Government Services, Inc., Properly Updated the Plan B Medicare Segment Pension Assets as of January 1, 2015 (A-07-18-00542)

Hospitals Reported Improved Preparedness for Emerging Infectious Diseases After the Ebola Outbreak (OEI-06-15-00230)

10-18-2018

Advisory Opinion 18-11 (regarding a health plan's proposal to pay its contracted providers and clinics to increase the amount of Early and Periodic Screening, Diagnostic, and Treatment services that they provide to the health plan's enrolled Medicaid beneficiaries)

States Follow a Common Framework in Responding to Breaches of Medicaid Data (OEI-09-16-00210)

10-17-2018

Florence Crittenton Services of Orange County, Inc., Did Not Always Claim Expenditures in Accordance With Federal Requirements (A-09-17-01002)

Updated Civil Monetary Penalties and Affirmative Exclusions

10-16-2018

Ohio Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries' Deaths 

10-15-2018

Updated: Work Plan

Updated Corporate Integrity Agreement List

10-11-2018

LEIE Database Updated with September 2018 Exclusions and Reinstatements

10-10-2018

Updated: Provider Self-Disclosure Settlements and CIA Reportable Events

10-09-2018

Protecting Against Cybersecurity Threats

10-04-2018

Wisconsin Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries� Deaths (A-05-17-00006)

Updated Corporate Integrity Agreement List

Updated Civil Monetary Penalties and Affirmative Exclusions

10-02-2018

Many Inpatient Rehabilitation Facility Stays Did Not Meet Medicare Coverage and Documentation Requirements (A-01-15-00500)

Updated Corporate Integrity Agreement List

10-01-2018

Most Wanted Deadbeat: David Adams owes over $4.2 million in child support

September

09-28-2018

Heartland Human Care Services, Inc., Generally Met Safety Standards, but Claimed Unallowable Rental Costs (A-05-16-00038)

09-27-2018

Fraud Risk Indicator

Medicare Advantage Appeal Outcomes and Audit Findings Raise Concerns About Service and Payment Denials (OEI-09-16-00410)

Updated Corporate Integrity Agreement List

09-26-2018

The Indian Health Service Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements (A-07-17-03227)

Nevada Implemented Some New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-09-17-01003)

Etheredge Chiropractic Received Unallowable Medicare Payments for Chiropractic Services (A-04-16-07064)

09-25-2018

Eye on Oversight: Emergency Response

Statistical Sampling: A Toolkit for MFCUs

New Hampshire Medicaid Fraud Control Unit: 2017 Onsite Review (OEI-09-17-00200)

New York Medicaid Fraud Control Unit: 2017 Onsite Inspection (OEI-12-17-00340)

New Jersey Medicaid Fraud Control Unit: 2017 Onsite Review (OEI-06-17-00520)

09-24-2018

Updated Civil Monetary Penalties and Affirmative Exclusions

09-21-2018

Colorado Implemented Many New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-07-17-06076)

09-20-2018

Medicare Payments for Clinical Diagnostic Laboratory Tests in 2017: Year 4 of Baseline Data  (OEI-09-18-00410)

First Coast Service Options, Inc., Overstated Medicare�s Share of the Medicare Segment Excess Pension Liabilities (A-07-18-00535)

09-18-2018

CMS Enrollment System Needs To Enhance Resiliency (A-18-17-06501)

09-17-2018

Treatment Planning and Medication Monitoring Were Lacking for Children in Foster Care Receiving Psychotropic Medication (OEI-07-15-00380)

Advisory Opinion 18-10 (regarding a surgical device and wound care product manufacturer's proposal to offer hospital customers a warranty program covering a suite of three products)

Updated: Work Plan

Updated Civil Monetary Penalties and Affirmative Exclusions

09-12-2018

National Institute of Transplantation, an Independent Histocompatibility Laboratory, Did Not Fully Comply With Medicare�s Cost-Reporting Requirements (A-09-16-02010)

Updated Corporate Integrity Agreement List

09-11-2018

FDA Should Further Integrate Its Review of Cybersecurity Into the Premarket Review Process for Medical Devices (OEI-09-16-00220)

09-10-2018

LEIE Database Updated with August 2018 Exclusions and Reinstatements

Updated Corporate Integrity Agreement List

09-07-2018

Updated Civil Monetary Penalties and Affirmative Exclusions

09-06-2018

Testimony of Ruth Ann Dorrill, Regional Inspector General, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations: Examining Federal Efforts to Ensure Quality of Care and Resident Safety in Nursing Homes

09-05-2018

Job Opening: Health Care Attorney Application Deadline: October 12

The Fort Peck Assiniboine and Sioux Tribes Improperly Administered Some Low-Income Home Energy Assistance Program Funds for Fiscal Years 2011 Through 2015 (A-07-18-04106)

Updated Provider Self-Disclosure Settlements

09-04-2018

Job Opening: Affirmative Litigation Attorney Application Deadline: September 18, 2018

August

08-29-2018

Updated Corporate Integrity Agreement List

David Kim Added to Top 10 Most Wanted Fugitives List

8-28-2018

STAT Op-Ed by Joanne M. Chiedi
Fraud, waste, and abuse in the Medicare hospice program is 'repellent'

08-23-2018

OIG Excludes Company and Owner from Federal Health Care Programs

Mississippi Did Not Comply With Federal Waiver and State Requirements at All 20 Adult Day Care Facilities Reviewed (A-04-17-00116)

Updated Corporate Integrity Agreement List

Updated Civil Monetary Penalties and Affirmative Exclusions

08-22-2018

Updated Corporate Integrity Agreement List

08-21-2018

Liberty Medical, LLC, Received Unallowable Medicare Payments for Inhalation Drugs (A-09-17-03019)

Virginia Did Not Claim Some Medicaid Administrative Costs for Its Medallion 3.0 Waiver Program In Accordance With Federal Requirements (A-03-17-00200)

Updated Civil Monetary Penalties and Affirmative Exclusions

Advisory Opinion 18-09 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay)

08-20-2018

Medicare Improperly Paid Hospitals Millions of Dollars for Intensity-Modulated Radiation Therapy Planning Services (A-09-16-02033)

Medicare Made Improper and Potentially Improper Payments for Emergency Ambulance Transports to Destinations Other Than Hospitals or Skilled Nursing Facilities (A-09-17-03017)

Updated Corporate Integrity Agreement List

08-16-2018

The Passamaquoddy Tribe's Pleasant Point Health Center Did Not Always Meet Federal and Tribal Health and Safety Requirements (A-01-17-01500)

California Created a Medicaid Program Vulnerability by Reporting Placeholders That Did Not Represent Actual Expenditures Supported by Documentation (A-09-15-02027)

California Claimed Millions of Dollars in Unallowable Federal Medicaid Reimbursement for Specialty Mental Health Services (A-09-15-02040)

Updated Virginia and Washington State False Claims Act Review Letters

08-15-2018

Updated: Work Plan

08-14-2018

Maryland Did Not Adequately Secure Its Medicaid Data and Information Systems (A-18-16-30520)

Advisory Opinion 18-08 (regarding a proposal by certain government-operated fire departments and fire protection districts to enter into a mutual aid agreement to provide backup emergency ambulance services and to bill for such services according to the billing practices in the jurisdiction where such services are rendered)

08-13-2018

Assistant Attorney General Benczkowski Announces Newark/Philadelphia Medicare Fraud Strike Force to Focus on Health Care Fraud and Illegal Opioid Prescriptions

Alaska Received Millions in Unallowable Bonus Payments (A-04-17-08059)

CMS Did Not Always Accurately Authorize Financial Assistance Payments to Qualified Health Plan Issuers in Accordance With Federal Requirements During the 2014 Benefit Year (A-02-15-02013)

08-10-2018

LEIE Database Updated with July 2018 Exclusions and Reinstatements

08-09-2018

Questionable Billing for Compounded Topical Drugs in Medicare Part D (OEI-02-16-00440)

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2016 Average Sales Prices (OEI-03-18-00120)

Updated Corporate Integrity Agreement List

08-08-2018

Medicare Compliance Review of WakeMed Raleigh Campus (A-04-17-04057)

Open Payments Data: Review of Accuracy, Precision, and Consistency in Reporting (OEI-03-15-00220)

08-06-2018

Advisory Opinion 18-07 (regarding a proposal from a group purchasing organization ("GPO") to serve as a purchasing agent on behalf of certain GPO-affiliated health care facilities on the same terms and conditions that apply to its unaffiliated members)

Updated Corporate Integrity Agreement List

Updated Civil Monetary Penalties and Affirmative Exclusions

08-03-2018

Illinois Did Not Always Comply With Maternal, Infant, and Early Childhood Home Visiting Program Requirements (A-05-16-00066)

Georgia Implemented Most New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-04-18-03578)

New Hampshire Implemented Most New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-01-18-02500)

Illinois Did Not Comply With Federal Waiver and State Requirements at 18 of 20 Adult Day Service Centers Reviewed (A-05-17-00028)

Updated Provider Self-Disclosure Settlements

08-02-2018

Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part A Administrative Costs for Fiscal Year 2013 (A-05-16-00052)

Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part B Administrative Costs for Fiscal Year 2013 (A-05-16-00053)

08-01-2018

Updated: Work Plan

Job Opening: Associate Counsel Application Deadline: August 24, 2018

July

07-31-2018

Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio

Media Materials: Vulnerabilities in Hospice Care

Eye on Oversight: Hospice

Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: Top Unimplemented Recommendations

07-25-2018

Updated Stipulated Penalties and Exclusion for Material Breach

07-23-2018

First Coast Service Options, Inc., Did Not Claim Some Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals (A-07-18-00536)

First Coast Service Options, Inc., Generally Claimed Allowable Pension Costs Through Its Incurred Cost Proposals (A-07-18-00534)

07-20-2018

Updated Corporate Integrity Agreement List

07-18-2018

Medicare Improperly Paid Providers for Nonemergency Ambulance Transports to Destinations Not Covered by Medicare (A-09-17-03018)

Setting Medicare Payment Rates for Clinical Diagnostic Laboratory Tests: Strategies To Ensure Data Quality (OEI-09-17-00050)

Updated Corporate Integrity Agreement List

Advisory Opinion 18-06 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 off the next renewal premium to policyholders who use a network hospital for an inpatient stay)

07-17-2018

Testimony of Gloria L. Jarmon, Deputy Inspector General for Audit Services, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Ways and Means Subcommittee on Oversight: Combating Fraud in Medicare: A Strategy for Success

07-16-2018

Updated: Work Plan

07-13-2018

The Office of the Secretary of Health and Human Services Did Not Comply with Federal Regulations for Chartered Aircraft and Other Government Travel Related to Former Secretary Price (A-12-17-00002)

The MEDIC Produced Some Positive Results but More Could be Done to Enhance its Effectiveness (OEI-03-17-00310)

07-12-2018

Weaknesses Exist in Medicaid Managed Care Organizations' Efforts To Identify and Address Fraud and Abuse (OEI-02-15-00260)

The Colorado Health Insurance Marketplace's Financial Management System Did Not Always Comply With Federal Requirements (A-07-17-02808)

07-10-2018

LEIE Database Updated with June 2018 Exclusions and Reinstatements

Opioids in Ohio Medicaid: Review of Extreme Use and Prescribing (OEI-05-18-00010)

The Indian Health Service's Controls Were Not Effective in Ensuring That Its Purchase Card Program Complied With Federal Requirements and Its Own Policy (A-07-16-05090)

Medicare Improperly Paid Providers for Items and Services Ordered by Chiropractors (A-09-17-03002)

Updated Civil Monetary Penalties and Affirmative Exclusions

07-06-2018

The Administration for Children and Families Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements (A-07-17-03225)

Some New York City Childcare Providers Did Not Always Comply With Health and Safety Requirements (A-02-16-02003)

University of Wisconsin Hospitals and Clinics Authority Incorrectly Billed Medicare Inpatient Claims With Severe Malnutrition (A-03-17-00005)

Updated Provider Self-Disclosure Settlements

07-05-2018

Updated Civil Monetary Penalties and Affirmative Exclusions

June

06-29-2018

Michigan Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Brokerage Program (A-05-16-00021)

CMS Did Not Detect Some Inappropriate Claims for Durable Medical Equipment in Nursing Facilities (OEI-06-16-00380)

06-28-2018

2018 National Takedown

Featured Topic: Combatting the Opioid Epidemic

Opioid Use in Medicare Part D Remains Concerning (OEI-02-18-00220)

Toolkit: Using Data Analysis To Calculate Opioid Levels and Identify Patients At Risk of Misuse or Overdose (OEI-02-17-00560)

Entities Generally Met Federal Select Agent Program Internal Inspection Requirements But CDC Could Do More To Improve Effectiveness (OEI-04-15-00431)

06-27-2018

Testimony of Brian P. Ritchie, Assistant Inspector General for Audit Services, Office of Inspector General, U.S. Department of Health and Human Services: Senate Committee on Homeland Security and Governmental Affairs: Medicaid Fraud and Overpayments: Problems and Solutions

Updated: Work Plan

Tennessee Medicaid Fraud Control Unit: 2017 Onsite Inspection (OEI-12-17-00230)

06-26-2018

Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2018 (OEI-05-18-00240)

Updated Corporate Integrity Agreement List

06-25-2018

Advisory Opinion 18-05 (regarding an arrangement under which a hospital has established a caregiver center that provides or arranges for free or reduced-cost support services to caregivers in the local community)

06-22-2018

Florence Crittenton Services of Orange County, Inc., Did Not Always Meet Applicable Safety Standards Related to Unaccompanied Alien Children (A-09-16-01005)

06-19-2018

Updated Corporate Integrity Agreement List

06-18-2018

Updated Civil Monetary Penalties and Affirmative Exclusions

06-15-2018

Updated: Work Plan

06-14-2018

Advisory Opinion 18-04 regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby insurance companies would contract indirectly with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for their policyholders and, in turn, would provide a premium credit of $100 to policyholders who use a network hospital for an inpatient stay

06-13-2018

Podcast: Pain Management Doctor Was A "One-Man Crime Wave"

Nebraska Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-07-17-03224)

Illinois Implemented Most New Criminal Background Check Requirements for Childcare Providers, but Challenges Remain for Unimplemented Requirements (A-05-17-00047)

Updated Civil Monetary Penalties and Affirmative Exclusions

06-12-2018

Most Medicare Claims for Replacement Positive Airway Pressure Device Supplies Did Not Comply With Medicare Requirements (A-04-17-04056)

Companion Data Services, LLC, Did Not Claim Some Allowable Pension Costs Through Its Incurred Cost Proposals (A-07-17-00528)

Minnesota Did Not Comply With Federal Waiver and State Requirements for All 20 Adult Day Care Centers Reviewed (A-05-17-00009)

Ohio Did Not Always Comply With Requirements Related to the Case Management of Children in Foster Care (A-05-16-00022)

06-08-2018

LEIE Database Updated with May 2018 Exclusions and Reinstatements

Texas Made Increased Payments for Services Rendered by Eligible Primary Care Providers Under Federal Requirements (A-06-17-09003)

Nevada Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-09-15-02039)

Updated Corporate Integrity Agreement List

06-07-2018

The Food and Drug Administration Computed Prescription Drug User Fee Rates Accurately (A-05-17-00040)

06-06-2018

New York Claimed Federal Reimbursement for Consumer-Directed Personal Assistance Services That Did Not Meet Medicaid Requirements (A-02-16-01026)

Updated Provider Self-Disclosure Settlements

06-05-2018

2017 Performance Data for the Senior Medicare Patrol Projects (OEI-02-18-00130)

Updated Corporate Integrity Agreement List

06-04-2018

Increases in Reimbursement for Brand-Name Drugs in Part D (OEI-03-15-00080)

Podcast: Increases in Reimbursement for Brand-Name Drugs in Part D

06-01-2018

Semiannual Report to Congress

May

05-31-2018

Advisory Opinion 18-03 regarding a federally qualified health center look-alike's proposal to provide information technology items and services, without charge, to a county Department of Health's clinic to facilitate telemedicine encounters

Updated Civil Monetary Penalties and Affirmative Exclusions

05-30-2018

HRSA Helped Health Centers With Elevated Risks and Can Continue To Take Additional Steps (OEI-05-14-00470)

05-29-2018

Testimony of Maureen Dixon, Special Agent in Charge, Philadelphia Regional Office, Office of Investigations, Office of Inspector General, Department of Health and Human Services: Senate Committee on Finance Health Care Subcommittee Field Hearing: Examining Efforts to Prevent Opioid Overutilization and Misuse in Medicare and Medicaid

05-25-2018

Eye on Oversight: Corporate Integrity Agreements

05-24-2018

Round 2 Competitive Bidding for Enteral Nutrition: Continued Access for Vast Majority of Beneficiaries (OEI-01-15-00042)

Round 2 Competitive Bidding for Oxygen: Continued Access for Vast Majority of Beneficiaries (OEI-01-15-00041)

CMS Did Not Always Provide Accurate Medicaid Unit Rebate Offset Amounts to State Medicaid Agencies (A-07-17-06074)

Updated Corporate Integrity Agreement List

05-23-2018

Testimony of Gary Cantrell, Deputy Inspector General for Investigations, Office of Investigations, Office of Inspector General, Department of Health and Human Services: Senate Special Committee on Aging: Preventing and Treating Opioid Misuse Among Older Americans

Updated Civil Monetary Penalties and Affirmative Exclusions

05-22-2018

The South African National Department of Health Did Not Always Manage and Expend the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements (A-04-17-01002)

05-18-2018

Iowa Complied With Most Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-07-17-03221)

Missouri Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-07-16-03216)

05-16-2018

The University of Alabama at Birmingham Overstated Chilled Water Costs in Its Facilities and Administrative Cost Proposal Audit (A-04-14-00095)

Wisconsin Physicians Service Insurance Corporation Understated Medicare Administrative Contract Allowable Pension Costs (A-07-17-00530)

Wisconsin Physicians Service Insurance Corporation Understated Medicare�s Share of the Medicare Segment Excess Pension Assets (A-07-17-00529)

05-15-2018

Testimony of Ann Maxwell, Assistant Inspector General for Evaluation and Inspections, Office of Inspector General, Department of Health and Human Services: Senate Committee on Health, Education, Labor, and Pensions: Examining Oversight Reports on the 340B Drug Pricing Program

Updated: Work Plan

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 2017 (A-17-18-52000)

05-14-2018

New Most Wanted Fugitive Posted: Angel Lagoa allegedly paid illegal kickbacks to patient recruiters in exchange for beneficiary information.

05-11-2018

Most of New York's Claims for Federal Reimbursement for Monthly Personal Emergency Response Service Charges Did Not Comply With Medicaid Requirements (A-02-15-01019)

05-09-2018

Updated Civil Monetary Penalties and Affirmative Exclusions

05-08-2018

LEIE Database Updated with April 2018 Exclusions and Reinstatements

Daniel R. Levinson's Keynote Address at the 2018 HCCA Compliance Institute

The National Institutes of Health, Division of Financial Advisory Services Did Not Always Establish Final Indirect Cost Rates in Accordance With Federal Requirements (A-04-17-04059)

Updated Corporate Integrity Agreement List

05-07-2018

Advisory Opinion 18-02 (regarding an arrangement where a company that manufactures, distributes, and sells medical device and pharmaceutical products provides a limited number of free sample ostomy products to patients and contracts with a third party to conduct follow-up customer satisfaction surveys)

Updated Corporate Integrity Agreement List

Cahaba Safeguard Administrators, LLC, Understated Medicare Administrative Contract Allowable Pension Costs (A-07-17-00526)

Cahaba Government Benefits Administrators, LLC, Understated Medicare Administrative Contract Allowable Pension Costs (A-07-17-00525)

Cahaba Government Benefits Administrators, LLC, Generally Claimed Allowable Medicare Pension Costs (A-07-17-00524)

Cahaba Government Benefits Administrators, LLC, Overstated Its Medicare Segment Pension Assets (A-07-17-00522)

05-04-2018

Florida Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid  (A-04-17-08052)

Cahaba Safeguard Administrators, LLC, Understated Its Medicare Segment Pension Assets (A-07-17-00523)

First Coast Service Options, Inc.'s, Postretirement Benefit Costs Were Reasonable and Allowable (A-07-17-00501)

05-03-2018

Updated Provider Self-Disclosure Settlements

05-01-2018

This is Real: Go Undercover with Our New Podcast

April

04-30-2018

Wanted: Amaury Perez

Updated Civil Monetary Penalties and Affirmative Exclusions

04-24-2018

Colorado Did Not Always Comply With Federal Requirements When Expending Federal Establishment Grant Funds Allocated for Its Shared Eligibility System Costs (A-07-16-02804)

04-20-2018

The National Institute of Health in Mozambique Did Not Always Manage and Expend the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements (A-04-16-04051)

Updated Corporate Integrity Agreement List

04-18-2018

The Indian Health Service's Controls Were Not Effective in Ensuring That Its Travel Card Program Complied With Federal Requirements and Its Own Policy (A-07-16-05091)

CMS's Policies and Procedures Were Generally Effective in Ensuring That Prescription Drug Coverage Capitation Payments Were Not Made After the Beneficiaries' Dates of Death (A-07-16-05088)

04-16-2018

New: Compliance Resource Portal

Updated: Work Plan

04-13-2018

CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements (A-05-16-00058)

Colorado Claimed Some Unallowable Medicaid Payments for Targeted Case Management Services (A-07-16-03215)

Idaho Received Millions in Unallowable Bonus Payments (A-04-17-08056)

04-12-2018

Testimony of Megan H. Tinker Senior Advisor for Legal Review Office of Counsel to the Inspector General, Office of Inspector General, Department of Health and Human Services: House Committee on Oversight and Government Reform, Subcommittee on Government Operations Subcommittee on Intergovernmental Affairs: Improper Payments in State?Administered Programs: Medicaid

04-11-2018

Most Wanted Fugitive: Ebong Tilong

Updated Corporate Integrity Agreement List

Updated Civil Monetary Penalties and Affirmative Exclusions

04-10-2018

LEIE Database Updated with March 2018 Exclusions and Reinstatements

04-09-2018

Texas Did Not Make Increased Primary Care Provider Payments and Claim Reimbursement in Accordance With Federal Requirements (A-06-15-00045)

04-06-2018

FY 2017 Health Care Fraud and Abuse Control Program Report

04-04-2018

Updated Provider Self-Disclosure Settlements

March

03-30-2018

Medicaid Fraud Control Units Fiscal Year 2017 Annual Report (OEI-09-18-00180)

03-29-2018

Drug Supply Chain Security: Dispensers Received Most Tracing Information (OEI-05-16-00550)

03-28-2018

Updated Corporate Integrity Agreement List

03-27-2018

CAPTURED: Antonio Quevedo-Ledo

03-23-2018

Many Medicare Claims for Outpatient Physical Therapy Services Did Not Comply With Medicare Requirements (A-05-14-00041)

Oklahoma Did Not Have Procedures to Identify Provider-Preventable Conditions on Some Inpatient Hospital Claims (A-06-16-08004)

03-22-2018

Some Washington State Group-Care Facilities for Children in Foster Care Did Not Always Comply With State Health and Safety Requirements (A-09-16-01006)

Aurum Institute Generally Managed and Expended the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements  (A-04-17-01003)

New Jersey Claimed Federal Medicaid Reimbursement for Children's Partial Hospitalization Services That Did Not Meet Federal and State Requirements (A-02-16-01008)

New York Did Not Comply With Federal Grant Requirements for Claiming Marketplace Contract Costs to Medicaid and the Children's Health Insurance Program  (A-02-15-01014)

03-21-2018

Small Business Innovation Research (SBIR) Fraud

03-16-2018

Updated Civil Monetary Penalties and Affirmative Exclusions

03-15-2018

Updated: Work Plan

Hospitals Did Not Comply With Medicare Requirements for Reporting Certain Cardiac Device Credits (A-05-16-00059)

Updated Corporate Integrity Agreement List

03-14-2018

Updated Civil Monetary Penalties and Affirmative Exclusions

03-12-2018

BCFS Health and Human Services Did Not Always Comply With Federal Requirements Related to Less-Than-Arm's-Length Leases (A-06-16-07007)

Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2017 (A-18-17-11200)

03-09-2018

Oklahoma Did Not Always Comply With Requirements for Providing Health Care Services to Children in Foster Care (A-06-16-07006)

Updated Provider Self-Disclosure Settlements

03-08-2018

Reliance on Unverified Patient Lists Creates a Vulnerability in Home Health Surveys (OEI-05-16-00510)

Updated Civil Monetary Penalties and Affirmative Exclusions

03-07-2018

Updated Corporate Integrity Agreement List

03-06-2018

LEIE Database Updated with February 2018 Exclusions and Reinstatements

03-02-2018

Entities' Experiences and Perceptions of Reporting the Theft, Loss, and Release of Select Agents or Toxins to CDC (OEI-04-15-00432)

Updated Corporate Integrity Agreement List

03-01-2018

Updated Civil Monetary Penalties and Affirmative Exclusions

February

02-27-2018

Advisory Opinion 18-01 (regarding the effect of your exclusion from Medicare, Medicaid, and all other Federal health care programs)

02-23-2018

The National Institutes of Health Did Not Always Administer Superfund Appropriations During Fiscal Year 2015 in Accordance With Federal Requirements (A-04-16-04046)

02-21-2018

Medicare Compliance Review of Memorial University Medical Center (A-04-17-08055)

The Association for Public Health Laboratories Managed Global Health Security Agenda Funds in Accordance With Federal Requirements (A-04-17-02004)

California Made Medicaid Payments on Behalf of Newly Eligible Beneficiaries Who Did Not Meet Federal and State Requirements (A-09-16-02023)

Updated Corporate Integrity Agreement List

02-20-2018

Fall Internship Application

Arizona Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02031)

Medicare Improperly Paid Providers for Specimen Validity Tests Billed in Combination With Urine Drug Tests  (A-09-16-02034)

02-16-2018

Medicare Needs Better Controls To Prevent Fraud, Waste, and Abuse Related to Chiropractic Services (A-09-16-02042)

02-15-2018

Updated: Work Plan

Wisconsin Physicians Service Paid Providers for Hyperbaric Oxygen Therapy Services That Did Not Comply With Medicare Requirements (A-01-15-00515)

Arkansas Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-06-16-00018)

Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2016 (A-18-17-11300)

02-13-2018

Updated Corporate Integrity Agreement List

Updated Civil Monetary Penalties and Affirmative Exclusions

02-12-2018

FY 2019 Congressional Budget Justification

02-09-2018

Updated Corporate Integrity Agreement List

02-08-2018

Henry J. Austin Health Center, Inc., a Health Resources and Services Administration Grantee, Did Not Comply With Federal Grant Requirements (A-02-17-02002)

The Administration for Children and Families Region II Did Not Always Resolve Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements (A-02-16-02009)

02-07-2018

LEIE Database Updated with January 2017 Exclusions and Reinstatements

Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Pension Costs Through Its Incurred Cost Proposals (A-07-17-00506)

CGS Administrators, LLC, Did Not Claim Some Allowable Pension Costs Through Its Incurred Cost Proposals (A-07-17-00513)

02-06-2018

Medicare Compliance Review of the University of Michigan Health System (A-05-16-00064)

Updated Corporate Integrity Agreement List

January

01-23-2018

North Carolina Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-04-17-02500)

Medicare Compliance Review of Carolinas Medical Center (A-04-16-04049)

01-19-2018

Testimony of Gloria Jarmon, Deputy Inspector General for the Office of Audit Services, Department of Health and Human Services: House Committee on Energy and Commerce, Subcommittee on Oversight and Investigations: Safety of the U.S. Food Supply: Continuing Concerns Over the Food and Drug Administration's Food-Recall Process

Updated Corporate Integrity Agreement List

01-18-2018

Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2017 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00354)

Independent Attestation Review: Substance Abuse and Mental Health Services Administration Fiscal Year 2017 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00353)

Independent Attestation Review: National Institutes of Health Fiscal Year 2017 Detailed Accounting Submissions and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00352)

Independent Attestation Review: Indian Health Service Fiscal Year 2017 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00351)

01-17-2018

Joint Report: Ensuring Beneficiary Health and Safety in Group Homes Through State Implementation of Comprehensive Compliance Oversight

Testimony of Gary Cantrell, Deputy Inspector General for Investigations, Office of Investigations, Office of Inspector General, Department of Health and Human Services: House Committee on Ways and Means, Subcommittee on Oversight: The Opioid Crisis: The Current Landscape and CMS Actions to Prevent Opioid Misuse

Wisconsin Physicians Service Insurance Corporation Did Not Claim Some Allowable Medicare Pension Costs (A-07-17-00519)

Wisconsin Physicians Service Insurance Corporation Understated Its Allocable Pension Costs (A-07-17-00520)

Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2017 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-18-00355)

01-16-2018

Updated: Work Plan

Medicare Advantage Encounter Data Show Promise for Program Oversight, But Improvements Are Needed (OEI-03-15-00060)

Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Employees' Pension Plan (A-07-17-00516)

Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Managerial Retirement Program for Selected Locations (A-07-17-00517)

Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Managerial Pension Plan (A-07-17-00518)

01-09-2018

New York Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries (A-02-15-01015)

Tennessee Managed Care Organizations Received Medicaid Capitation Payments After Beneficiary's Death (A-04-15-06190)

Georgia Made Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid Identification Numbers (A-04-16-07061)

Texas Did Not Appropriately Spend Some State Balancing Incentive Payments Program Funds (A-06-15-00041)

Updated Civil Monetary Penalties and Affirmative Exclusions

01-08-2018

Texas Did Not Always Calculate Physician Supplemental Payments Made to the Texas Tech University Health Institutions in Accordance With Federal and State Requirements (A-06-12-00043)

Nebraska Did Not Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-07-13-06046)

Texas Did Not Bill Manufacturers for Some Rebates for Pharmacy Drugs of Medicaid Managed-Care Organizations (A-06-16-00004)

Indiana Did Not Always Comply With Maternal, Infant, and Early Childhood Home Visiting Program Requirements (A-05-16-00056)

Updated Corporate Integrity Agreement List

01-05-2018

OIG Letter to PhRMA: Drug Companies that Provide Free Drugs to Federal Health Care Program Beneficiaries Impacted by Caring Voice Coalition, Inc.'s Decision Not to Provide Patient Assistance in 2018

Advisory Opinion 17-09 (regarding an arrangement in which certain neurosurgeons have agreed to implement cost-reduction measures in designated surgical procedures performed at a medical center, and the medical center will share with such neurosurgeons a percentage of its cost savings resulting from these measures)

01-04-2018

Updated Corporate Integrity Agreement List

01-03-2018

LEIE Database Updated with December 2017 Exclusions and Reinstatements

Updated Provider Self-Disclosure Settlements

---

2017

December

12-29-2017

Updated Civil Monetary Penalties and Affirmative Exclusions

New York Did Not Comply With Federal Grant Requirements for Allocating and Claiming Marketplace Contract Costs (A-02-15-02008)

12-26-2017

The Food and Drug Administration's Food-Recall Process Did Not Always Ensure the Safety of the Nation's Food Supply (A-01-16-01502)

12-22-2017

The Administration for Children and Families Region X Did Not Always Resolve Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements (A-09-16-01004)

12-21-2017

Lincare Pharmacy Services Inc. Generally Complied With Medicare Requirements When Billing for Inhalation Drugs (A-09-16-02037)

Taxpayers Could See More than $4.4 Billion Returned to Treasury Plus $Billions in Estimated 2017 Savings from OIG Recommendations

12-20-2017

Eye on Oversight: 2017 Year in Review

Potential Misclassifications Reported by Drug Manufacturers May Have Led to $1 Billion in Lost Medicaid Rebates (OEI-03-17-00100)

Updated Corporate Integrity Agreement List

12-19-2017

The Administration for Children and Families Did Not Always Resolve American Indian and Alaska Native Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements (A-06-17-07003)

Summary Report for Fiscal Year 2016 OIG Penetration Testing of Four HHS Operating Division Networks (A-18-17-08500)

12-18-2017

The State of North Carolina Did Not Meet Federal Information System Security Requirements for Safeguarding Its Medicaid Eligibility Determination Systems and Data (A-07-16-00486)

Some Massachusetts Group Homes for Children in Foster Care Did Not Always Comply With State Health and Safety Requirements (A-01-16-02500)

Updated Civil Monetary Penalties and Affirmative Exclusions

12-15-2017

Updated: Work Plan

Advisory Opinion 17-08 (regarding your proposal to develop a state-wide network of nursing facilities that would provide discounts on the daily rates they charge to private long-term care insurers and the insurers' policyholders)

12-14-2017

Followup Review: CMS's Management of the Quality Payment Program (OEI-12-17-00350)

Updated Corporate Integrity Agreement List

12-11-2017

Advisory Opinion 17-07 (regarding a pharmaceutical manufacturer's proposal to collaborate with a trade association, a Medicare Advantage plan, and a hospital system to implement, fund, and evaluate a pilot program to provide the Medicare Advantage plan pharmacists who conduct medication therapy management services with new technology that would permit real-time electronic access to patient discharge information)

12-08-2017

Medicaid Fraud Control Units: Investigation and Prosecution of Fraud and Beneficiary Abuse in Medicaid Personal Care Services (OEI-12-16-00500)

Office of Refugee Resettlement Unaccompanied Alien Children Grantee Review—His House (A-04-16-03566)

12-07-2017

Pine Bluff Jefferson County Economic Opportunities Commission Did Not Always Operate Its Head Start Program in Accordance With Federal Requirements (A-06-16-00013)

Not All of Missouri's Child Care Subsidy Program Payments Complied With Federal and State Requirements (A-07-15-04226)

Two Indian Health Service Hospitals Had System Security and Physical Controls for Prescription Drug and Opioid Dispensing but Could Still Improve Controls (A-18-16-30540)

Updated Corporate Integrity Agreement List

12-06-2017

Updated Provider Self-Disclosure Settlements

12-05-2017

LEIE Database Updated with November 2017 Exclusions and Reinstatements

Updated Corporate Integrity Agreement List

12-01-2017

CMS Did Not Adequately Address Discrepancies in the Coding Classification for Kwashiorkor (A-03-14-00010)

Texas Managed Care Organizations Received Medicaid Capitation Payments After Beneficiary's Death (A-06-16-05004)

November

11-30-2017

Fall Semiannual Report to Congress

11-29-2017

Updated Corporate Integrity Agreement List

11-28-2017

Final Notice of Rescission of Advisory Opinion 06-04 (rescinds Advisory Opinion 06-04, which concerned a nonprofit, tax-exempt, charitable corporation's proposal to provide financially needy Medicare beneficiaries with assistance with premiums and cost-sharing obligations)

New Jersey Claimed Hundreds of Millions in Unallowable or Unsupported Medicaid School-Based Reimbursement (A-02-15-01010)

11-27-2017

Excluding Noncovered Versions When Setting Payment for Two Part B Drugs Would Have Resulted in Lower Drug Costs for Medicare and its Beneficiaries (OEI-12-17-00260)

11-20-2017

Updated Civil Monetary Penalties and Affirmative Exclusions

11-17-2017

CMS Generally Met Requirements in Round 2 of the DMEPOS Competitive Bidding Program (A-05-14-00049)

Updated Corporate Integrity Agreement List

11-16-2017

Eye on Oversight Video: Grant Management

Medicare Compliance Review of Rush University Medical Center (A-05-16-00062)

U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, but Key Areas Require Improvement (A-17-17-02018)

Advisory Opinion 17-06 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby an insurance company would indirectly contract with hospitals for discounts on the otherwise applicable Medicare inpatient deductibles for its policyholders and, in turn, would provide a premium credit of $100 to policyholders who use a network hospital for an inpatient stay)

11-15-2017

Top Management & Performance Challenges Facing HHS

Updated: Work Plan

Updated: CIA Reportable Event Settlements

11-13-2017

North Carolina Did Not Comply With Federal and State Requirements When Making Medicaid Cost-Sharing Payments for Professional Medical Services (A-04-16-04054)

11-09-2017

Ohio Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-16-00013)

Oklahoma Did Not Correctly Process Adjustments to Medicare Crossover Claims (A-06-16-08012)

New York Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-02-15-01024)

11-08-2017

From Military Veteran to OIG Special Agent

11-07-2017

LEIE Database Updated with October 2017 Exclusions and Reinstatements

Kansas Received Millions in Unallowable Bonus Payments (A-04-16-08050)

Ohio Received Millions in Unallowable Bonus Payments (A-04-16-08049)

11-06-2017

Minnesota Did Not Comply With Federal Waiver and State Requirements for 18 of 20 Family Adult Foster Care Homes Reviewed (A-05-16-00044)

Updated Corporate Integrity Agreement List

11-03-2017

First Coast Service Options, Inc., Generally Claimed Allowable Medicare Pension Costs (A-07-16-00495)

First Coast Service Options, Inc., Understated Its Medicare Segment Pension Assets (A-07-16-00494)

First Coast Service Options, Inc., Understated Its Allocable Pension Costs (A-07-16-00493)

11-02-2017

CMS Ensured Nearly All Part D Drug Records Contained Valid Prescriber Identifiers in 2016 (OEI-03-17-00040)

New York Did Not Always Ensure That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV-E Foster Care Payments Were Recorded and Investigated in Accordance With State Requirements as Required by Federal Law (A-02-15-02014)

Updated Corporate Integrity Agreement List

Updated Provider Self-Disclosure Settlements

11-01-2017

Southeast Arkansas Community Action Corporation Did Not Always Operate Its Head Start Program in Accordance With Federal Regulations (A-06-16-00015)

Updated Civil Monetary Penalties and Affirmative Exclusions

Updated Corporate Integrity Agreement List

October

10-31-2017

Testimony of James A. Cannatti III, Senior Counselor for Health Information Technology, Office of Inspector General, U.S. Department of Health and Human Services: Senate Committee on Health, Education, Labor, and Pensions: Implementation of the 21st Century Cures Act: Achieving the Promise of Health Information Technology

10-27-2017

Updated Civil Monetary Penalties and Affirmative Exclusions

10-25-2017

Review of The Department of Health and Human Services (HHS) Cancellation of Marketplace Enrollment Outreach Efforts (OEI-12-17-00290)

HRSA Complied With Federal and HHS Grant Policies When Awarding Zika Response and Preparedness Appropriations Act Funds During Fiscal Year 2017 

10-23-2017

CMS Ensured That Medicare Shared Savings Program Beneficiaries Were Properly Assigned: Beneficiaries Were Assigned to Only One Accountable Care Organization and Were Not Assigned to Other Shared Savings Programs (A-09-17-03010)

Updated Civil Monetary Penalties and Affirmative Exclusions

10-19-2017

Updated Corporate Integrity Agreement List

10-16-2017

Updated: Work Plan

10-12-2017

CMS's Policies and Procedures Were Generally Effective in Ensuring That Capitation Payments Were Not Made After Beneficiaries' Dates of Death (A-07-16-05087)

10-11-2017

Job Opening: Attorney Application Deadline: October 20, 2017

Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part B Administrative Costs for Fiscal Year 2012 (A-05-15-00047)

Updated Civil Monetary Penalties and Affirmative Exclusions

10-06-2017

Some Ohio Group Homes Did Not Always Comply With Foster Care Health and Safety Requirements (A-05-16-00049)

National Government Services Properly Claimed Allowable Administrative Costs for the Last Three Quarters of Fiscal Years 2011 and 2012 Under Medicare Contract 00630 (A-05-15-00045)

National Government Services Properly Claimed Allowable Administrative Costs for the Last Three Quarters of Fiscal Years 2011 and 2012 Under Medicare Contract 00130 (A-05-16-00034)

National Government Services Properly Claimed Allowable Administrative Costs for the Last Three Quarters of Fiscal Years 2011 and 2012 Under Medicare Contract 00450 (A-05-16-00035)

Updated Civil Monetary Penalties and Affirmative Exclusions

10-05-2017

The Food and Drug Administration Generally Spent Prescription Drug User Fee Collections Appropriately (A-05-16-00040)

The Administration for Children and Families Region VI Did Not Always Resolve Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements  (A-06-16-00019)

The District of Columbia Claimed Some Day Treatment Program Services That Were Not in Compliance With Federal or District Requirements (A-03-16-00201)

10-04-2017

Podcast: Health IT Security

LEIE Database Updated with September 2017 Exclusions and Reinstatements

Updated Corporate Integrity Agreement List

10-03-2017

Medicare Payments for Clinical Diagnostic Laboratory Tests in 2016: Year 3 of Baseline Data (OEI-09-17-00140)

The Turtle Mountain Band of Chippewa Indians Improperly Administered Some Low-Income Home Energy Assistance Program Funds for Fiscal Years 2010 Through 2013 (A-07-16-04233)

Updated Provider Self-Disclosure Settlements

10-02-2017

Protect Yourself from Medical Identity Theft

Shortcomings of Device Claims Data Complicate and Potentially Increase Medicare Costs for Recalled and Prematurely-Failed Devices (A-01-15-00504)

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2015 Average Sales Prices  (OEI-03-17-00360)

Wyoming State Medicaid Fraud Control Unit: 2016 Onsite Review (OEI-09-16-00530)

September

09-29-2017

A Few States Fell Short in Timely Investigation of the Most Serious Nursing Home Complaints: 2011-2015 (OEI-01-16-00330)

Enhancements Needed in the Tracking and Collection of Medicare Overpayments Identified by ZPICs and PSCs  (OEI-03-13-00630)

The Centers for Medicare & Medicaid Services Could Improve Performance Measures Associated With the Fraud Prevention System  (A-01-15-00509)

Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part A Administrative Costs for Fiscal Year 2012  (A-05-15-00046)

09-28-2017

Hawaii Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02029)

Washington State Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02028)

CMS Did Not Provide Effective Oversight To Ensure That State Marketplaces Always Properly Determined Individuals' Eligibility for Qualified Health Plans and Insurance Affordability Programs (A-09-16-01002)

Some Oklahoma Group Homes Did Not Always Comply With State Requirements (A-06-16-07004)

Updated Civil Monetary Penalties and Affirmative Exclusions

09-27-2017

Challenges Remain in FDA's Inspections of Domestic Food Facilities (OEI-02-14-00420)

09-26-2017

California Did Not Always Ensure That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV E Foster Care Payments Were Properly Recorded, Investigated, and Resolved (A-09-16-01000)

Integrated Health Administrative Services, Inc., Improperly Claimed Medicare Part B Reimbursement for Portable X-ray Services (A-02-15-01008)

Minnesota Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Program (A-05-15-00026)

Massachusetts Generally Complied With State Requirements To Ensure Children Who Were Title IV-E Eligible and Residing in Foster Care Congregate Care Group Homes Received Required Medical Services (A-01-16-02501)

09-22-2017

Kentucky State Medicaid Fraud Control Unit: 2017 Onsite Review (OEI-06-17-00030)

Alaska State Medicaid Fraud Control Unit: 2016 Onsite Review (OEI-09-16-00430)

Medicare Compliance Review of Parkridge Medical Center, Inc., for 2014 and 2015 (A-04-16-08048)

Vulnerabilities Remain in Medicare Hospital Outlier Payments (A-07-14-02800)

09-21-2017

Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities (A-09-16-02026)

09-20-2017

OHRP Should Inform Potential Complainants of How They Can Seek Whistleblower Protections (OEI-01-15-00351)

Alabama Did Not Adequately Secure Its Medicaid Data and Information Systems (A-04-15-05065)

09-19-2017

Wisconsin Did Not Always Comply With Maternal, Infant, and Early Childhood Home Visiting Program Requirements (A-05-15-00049)

Blue Cross Blue Shield Association Generally Claimed Allowable Medicare Postretirement Benefit Costs (A-07-17-00521)

Nevada Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02027)

Sierra Nevada Memorial Hospital Did Not Accurately Report Certain Wage Data, Resulting in Overpayments to California Hospitals (A-09-16-02044)

09-15-2017

Updated: Work Plan

Drug Supply Chain Security: Wholesalers Exchange Most Tracing Information (OEI-05-14-00640)

Updated Corporate Integrity Agreement List

09-13-2017

Job Opening: Experienced Litigator Application Deadline: September 27, 2017

Arkansas Did Not Make Supplemental Payments in Accordance With Federal Requirements (A-06-15-00042)

09-12-2017

New York State Improperly Claimed Medicaid Reimbursement for Some Managed Long-Term Care Payments  (A-02-15-01026)

CMS Oversight Must Continue Because All Remaining Consumer Operated and Oriented Plans Were Not Profitable and May Not Be Viable and Sustainable (A-05-16-00027)

Companion Data Services, LLC, Understated Its Allocable Pension Costs (A-07-17-00511)

Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets (A-07-17-00512)

Updated Provider Self-Disclosure Settlements

09-11-2017

OCIG Spring and Summer Internship Opportunities

Kansas Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-07-17-03218)

Blue Cross Blue Shield of South Carolina Overstated Its Allocable Qualified Pension Plan Costs (A-07-17-00509)

CMS and Its Claims Processing Contractors Issued Conflicting Guidance on the Proper Use of the KX Modifier for Part B Immunosuppressive Drug Claims  (A-06-15-00018)

09-08-2017

Challenges Appear to Limit States' Use of Medicaid Payment Suspensions (OEI-09-14-00020)

09-07-2017

LEIE Database Updated with August 2017 Exclusions and Reinstatements

Advisory Opinion 17-05 (regarding a retail pharmacy chain's proposal to allow Federal health care program beneficiaries to participate in a paid membership program that includes discounts on certain prescriptions and clinic services)

Updated Corporate Integrity Agreement List

09-05-2017

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2014 Average Sales Prices (OEI 03-16-00540)

Calculation of Potential Inflation-Indexed Rebates For Medicare Part B Drugs 2017 (OEI-12-17-00180)

09-01-2017

Oklahoma Did Not Adequately Oversee Its Medicaid Nonemergency Medical Transportation Program (A-06-16-00007)

August

08-31-2017

As Funding for BPA Research Increased, NIEHS Followed Its Peer Review Process While Also Exercising Its Discretion (OEI-01-15-00150)

Advisory Opinion 17-04 (regarding the use of a "preferred hospital" network as part of Medicare Supplemental Health Insurance ("Medigap") policies, whereby insurance companies indirectly contract with hospitals for discounts on the otherwise-applicable Medicare inpatient deductibles for their policyholders and, in turn, provide a premium credit of $100 to policyholders who use a network hospital for an inpatient stay)

08-30-2017

Updated Corporate Integrity Agreement List

08-29-2017

Fox Rehabilitation Claimed Unallowable Medicare Reimbursement for Outpatient Therapy Services (A-02-16-01004)

Accredo Health Group, Inc., Properly Billed Medicare for Inhalation Drugs (A-09-16-02022)

Medicare Shared Savings Program Accountable Care Organizations Have Shown Potential for Reducing Spending and Improving Quality (OEI-02-15-00450)

08-28-2017

Early Alert: The Centers for Medicare & Medicaid Services Has Inadequate Procedures To Ensure That Incidents of Potential Abuse or Neglect at Skilled Nursing Facilities Are Identified and Reported in Accordance With Applicable Requirements (A-01-17-00504)

Job Opening: Attorney Application Deadline: September 22, 2017

08-25-2017

Advisory Opinion 17-03 (regarding a pharmaceutical manufacturer's proposal to replace products that require specialized handling that could not be administered to patients for certain reasons, at no additional charge to the purchaser)

08-24-2017

TrailBlazer Health Enterprises, LLC, Claimed Some Unallowable Medicare Administrative Contract Pension Costs (A-07-17-00510)

08-23-2017

Colorado State Medicaid Fraud Control Unit: 2016 Onsite Review (OEI 06-16-00520)

08-22-2017

FDA Oversight of Tobacco Manufacturing Establishments (OEI-01-15-00300)

08-21-2017

Kentucky Did Not Always Perform Medicaid Eligibility Determinations for Non-Newly Eligible Beneficiaries in Accordance With Federal and State Requirements (A-04-16-08047)

Public Summary Report: The State of North Carolina Did Not Ensure That Federal Information System Security Requirements Were Met for Safeguarding Its Medicaid Claims Processing Systems and Data (A-07-16-00469)

08-18-2017

Public Summary Report: Information Technology Control Weaknesses Found in the New Mexico Human Services Department's Medicaid Eligibility Systems (A-06-16-05000)

A Brooklyn Chiropractor Received Unallowable Medicare Payments for Chiropractic Services (A-02-13-01047)

The Ministry of Health and Social Welfare National AIDS Control Program Did Not Always Manage and Expend PEPFAR Funds in Accordance With Award Requirements (A-04-16-04044)

The Administration for Children and Families Region IX Resolved Head Start Grantees' Single Audit Findings in Accordance With Federal Requirements (A-09-16-01003)

08-17-2017

Updated Corporate Integrity Agreement List

08-16-2017

Texas Improperly Received Medicaid Reimbursement for School-Based Health Services (A-06-14-00002)

08-15-2017

Updated: Work Plan

08-14-2017

TrailBlazer Health Enterprises, LLC, Understated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Assets (A-07-17-00507)

TrailBlazer Health Enterprises, LLC, Did Not Claim Some Allowable Medicare Pension Costs (A-07-17-00508)

08-10-2017

Maine Did Not Comply With Federal and State Requirements for Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities (A-01-16-00001)

Updated Civil Monetary Penalties and Affirmative Exclusions

Updated Corporate Integrity Agreement List

08-07-2017

Eye on Oversight: The Importance of OIG Audits

LEIE Database Updated with July 2017 Exclusions and Reinstatements

Updated Provider Self-Disclosure Settlements

08-04-2017

Medicare Paid New England Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays During Calendar Years 2013 and CY 2014 (A-01-15-00511)

Ohio Ensured That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV-E Foster Care Payments Were Recorded and Investigated in Accordance With State Requirements as Required by Federal Law (A-05-16-00020)

The Three Affiliated Tribes Improperly Administered Low-Income Home Energy Assistance Program Funds for Fiscal Years 2010 Through 2014 (A-07-16-04230)

Updated Corporate Integrity Agreement List

08-03-2017

Podcast: Independence of the Office for Human Research Protections

HHS's Office of Refugee Resettlement Improved Coordination and Outreach to Promote the Safety and Well-Being of Unaccompanied Alien Children (OEI-09-16-00260)

08-02-2017

Updated Corporate Integrity Agreement List

08-01-2017

Updated CIA Reportable Event Settlements

July

07-31-2017

OHRP Generally Conducted Its Compliance Activities Independently, But Changes Would Strengthen Its Independence (OEI-01-15-00350)

07-27-2017

Some Hospitals in Medicare Jurisdiction F Claimed Residents as More Than One Full-Time Equivalent (A-02-15-01028)

Some Hospitals in Medicare Jurisdiction E Claimed Residents as More Than One Full-Time Equivalent (A-02-15-01027)

07-26-2017

Eye on Oversight: Electronic Health Records

07-19-2017

Review of Pennsylvania Medicaid Managed Care Program Potential Savings With Minimum Medical Loss Ratio (A-03-15-00203)

07-18-2017

Testimony of Erin Bliss, Assistant Inspector General for Evaluation and Inspections, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Energy and Commerce: Subcommittee on Oversight and Investigations: "Examining HRSA's Oversight of the 340B Drug Pricing Program"

Palmetto Government Benefits Administrator, LLC, Understated Its Medicare Segment Pension Assets (A-07-17-00503)

Palmetto Government Benefits Administrator, LLC, Generally Claimed Allowable Medicare Pension Costs (A-07-17-00504)

Palmetto Government Benefits Administrator, LLC, Understated Its Medicare Segment Allocable Pension Costs (A-07-17-00505)

Updated Corporate Integrity Agreement List

07-17-2017

Updated: Work Plan

07-14-2017

First Coast Service Options, Inc., Understated Its Medicare Segment and Overstated Its Other Segment Allocable Postretirement Benefit Costs (A-07-17-00502)

First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs (A-07-17-00500)

First Coast Service Options, Inc., Overstated Its Medicare Segment Postretirement Benefit Assets (A-07-17-00499)

07-13-2017

2017 National Takedown

Opioids in Medicare Part D: Concerns about Extreme Use and Questionable Prescribing (OEI-02-17-00250)

07-12-2017

Updated Corporate Integrity Agreement List

07-10-2017

Updated Civil Monetary Penalties and Affirmative Exclusions

07-07-2017

Advisory Opinion 17-02 (regarding a hospital outpatient facility's proposal to reduce or waive, on a non-routine, unadvertised basis, cost-sharing amounts owed by financially needy Medicare beneficiaries for items and services furnished in connection with a clinical research study)

07-06-2017

Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2017 (OEI-05-17-00160)

Updated Provider Self-Disclosure Settlements

07-05-2017

LEIE Database Updated with June 2017 Exclusions and Reinstatements

Wisconsin Physicians Service Insurance Corporation Did Not Properly Settle Missouri Medicare Disproportionate Share Hospital Payments (A-07-16-04229)

Public Summary Report: Readiness of CDC's Strategic National Stockpile Could Be at Risk in Case of a Public Health Emergency (A-04-16-03554)

Louisiana Complied With the Requirements of the Social Security Act in Its Review of Cases of Credible Allegations of Medicaid Fraud (A-06-16-00010)

June

06-29-2017

Ariel Foundation Against Pediatric AIDS Managed and Expended the President's Emergency Plan for AIDS Relief Funds in Accordance with Award Requirements (A-04-16-04052)

06-27-2017

T-MSIS Data Not Yet Available for Overseeing Medicaid (OEI-05-15-00050)

06-21-2017

Management and Development for Health Did Not Always Manage the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements (A-04-16-04045)

06-19-2017

Updated Civil Monetary Penalties and Affirmative Exclusions

06-15-2017

Updated: Work Plan

Updated Corporate Integrity Agreement List

06-14-2017

Updated Civil Monetary Penalties and Affirmative Exclusions

06-13-2017

2016 Performance Data for the Senior Medicare Patrol Project (OEI-02-17-00220)

Updated Oklahoma State False Claims Act Review

Updated Corporate Integrity Agreement List

06-12-2017

Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did Not Comply With Federal Requirements (A-05-14-00047)

Review of Wisconsin Medicaid Managed Care Program Potential Savings With Minimum Medical Loss Ratio (A-05-15-00040)

Medicare Market Shares of Mail Order Diabetes Test Strips From October Through December 2016 (OEI-04-16-00473)

06-09-2017

Round 2 Competitive Bidding for CPAP/RAD: Disrupted Access Unlikely for Devices, Inconclusive for Supplies (OEI-01-15-00040)

06-08-2017

Eye on Oversight: Abuse in Nursing Homes

Updated Corporate Integrity Agreement List

06-07-2017

LEIE Database Updated with May 2017 Exclusions and Reinstatements

06-05-2017

Wisconsin State Medicaid Fraud Control Unit: 2016 Onsite Review (OEI-07-16-00240)

06-02-2017

Updated Corporate Integrity Agreement List

Updated Provider Self-Disclosure Settlements

06-01-2017

Spring 2017 Semiannual Report to Congress

May

05-31-2017

Updated Corporate Integrity Agreement List

05-30-2017

Texas Did Not Always Ensure That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV-E Foster Care Payments Were Recorded and Investigated in Accordance With Federal and State Requirements (A-06-15-00049)

05-26-2017

Minnesota Disbursed Only Part of Its Civil Money Penalty Collections, Limiting Resources To Protect and Improve Care for Nursing Facility Residents (A-05-16-00017)

Podcast: Combatting Opioid Abuse—OIG's Work Against the Opioid Epidemic

05-25-2017

Asian American and Pacific Islander Heritage Month

CDC Generally Met Its Inspection Goals for the Federal Select Agent Program; However, Opportunities Exist To Strengthen Oversight (OEI-04-15-00430)

05-24-2017

Updated Corporate Integrity Agreement List

05-23-2017

FY 2018 Congressional Budget Justification

05-22-2017

Medicare Could Save Millions by Eliminating the Lump-Sum Purchase Option for All Power Mobility Devices (A-05-15-00020)

05-19-2017

Medicaid Fraud Control Units Fiscal Year 2016 Annual Report (OEI-09-17-00210)

Public Summary Report: Virginia Did Not Adequately Secure Its Medicaid Data (A-04-15-05066)

05-18-2017

HHS Did Not Identify and Report Antideficiency Act Violations (A-03-13-03002)

05-17-2017

Compendium of Unimplemented Recommendations

05-16-2017

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 2016 (17-17-52000)

Medical Ambulance Services, Inc., Claimed Unallowable Reimbursement for Medicare Part B Ambulance Services (A-02-15-01016)

A Missouri Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Physical Therapy Services (A-07-14-01147)

Updated Civil Monetary Penalties and Affirmative Exclusions

05-15-2017

Kentucky Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries (A-04-15-08044)

Iowa Did Not Invoice Rebates to Manufacturers for Physician-Administered Drugs of Medicaid Managed-Care Organizations (A-07-16-06065)

CGS Administrators, LLC, Overstated Its CIGNA Pension Plan Medicare Segment Pension Assets and Understated Medicare's Share of Excess Pension Liabilities  (A-07-16-00470)

CGS Administrators, LLC, Understated Its CIGNA Pension Plan for Certain Former Employees Medicare Segment Pension Assets and Understated Medicare's Share of Excess Pension Assets (A-07-16-00491)

05-12-2017

CGS Administrators, LLC, Generally Claimed Allowable Medicare Pension Costs (A-07-16-00489)

CGS Administrators, LLC, Did Not Claim Some Allowable Medicare Administrative Contract Postretirement Benefit Costs (A-07-17-00498)

CGS Administrators, LLC, Claimed Some Unallowable Medicare Administrative Contract Pension Costs (A-07-16-00490)

05-09-2017

Service to the Nation: In the Military and HHS OIG

Briefing to The Honorable Gus Bilirakis, Subcommittee on Health, Committee on Energy and Commerce, House of Representatives Audit Briefing (A-02-17-02001)

05-08-2017

LEIE Database Updated with April 2017 Exclusions and Reinstatements

Updated Corporate Integrity Agreement List

05-04-2017

CMS Validated Hospital Inpatient Quality Reporting Program Data, But Should Use Additional Tools to Identify Gaming (OEI-01-15-00320)

Updated Provider Self-Disclosure Settlements

05-03-2017

Medicare Compliance Review of Mount Sinai Hospital for 2012 and 2013 (A-02-14-01019)

Updated Corporate Integrity Agreement List

Updated Civil Monetary Penalties and Affirmative Exclusions

05-02-2017

Testimony of Christi A. Grimm, Chief of Staff, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Energy and Commerce: Subcommittee on Oversight and Investigations: "Combatting Waste, Fraud, and Abuse in Medicaid's Personal Care Services Program"

April

04-28-2017

Economic Opportunity Commission of Nassau County, Inc., Claimed Some Unallowable Hurricane Sandy Disaster Relief Act Funds (A-02-15-02009)

Illinois Made Correct Medicaid Claim Adjustments (A-05-15-00031)

Medicare Compliance Review of the University of Arkansas for Medical Sciences Medical Center for 2013 and 2014 (A-06-16-00005)

Daniel R. Levinson Keynote Address at the 2017 HCCA Compliance Institute

04-27-2017

Indian Health and Human Services Resources

Updated Corporate Integrity Agreement List

04-21-2017

California Incorrectly Claimed Additional Medicaid Funding Authorized Under the Recovery Act When Reclaiming Overpayments Made to Bankrupt or Out-of-Business Providers (A-09-14-02030)

Florida Did Not Suspend Medicaid Payments to Some Providers That Had Credible Fraud Allegation Cases in Accordance With the Social Security Act (A-04-14-07046)

Ohio's and Michigan's Sales and Use Taxes on Medicaid Managed Care Organization Services Do Not Meet Broad-Based Requirement (A-03-16-00200)

04-20-2017

New Jersey Claimed Medicaid Reimbursement for Adult Partial Hospitalization Services That Did Not Comply With Federal and State Requirements (A-02-14-01015)

04-19-2017

Updated Corporate Integrity Agreement List

04-11-2017

Updated Provider Self-Disclosure Settlements

04-10-2017

Updated Civil Monetary Penalties and Affirmative Exclusions

04-07-2017

Ohio Made Incorrect Medicaid Payments to Providers for Full Vials of Herceptin (A-05-15-00032)

Texas Made Unallowable Medicaid Managed Care Payments for Beneficiaries Assigned More Than One Medicaid Identification Number (A-06-15-00024)

Updated Corporate Integrity Agreement List

04-06-2017

LEIE Database Updated with March 2017 Exclusions and Reinstatements

Updated Civil Monetary Penalties and Affirmative Exclusions

March

03-30-2017

Wisconsin Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-16-00014)

03-28-2017

Medicare Compliance Review of Jackson-Madison County General Hospital for Claims Paid From June 1, 2013, Through May 31, 2015 (A-04-15-04042)

03-27-2017

Measuring Compliance Program Effectiveness: A Resource Guide

03-24-2017

Mildmay Uganda Did Not Always Manage the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements (A-04-15-04039)

Missouri Properly Verified Correction of Deficiencies Identified During Surveys of Nursing Homes (A-07-16-03217)

03-22-2017

Mississippi Claimed Millions in Unallowable School-Based Medicaid Administrative Costs (A-04-15-00103)

Updated Civil Monetary Penalties and Affirmative Exclusions

03-20-2017

Alta Bates Medical Center Inaccurately Reported Wage Data, Resulting in Medicare Overpayments Audit (A-09-14-02035)

Cleveland Clinic Lerner College of Medicine Inappropriately Drew Down Hurricane Sandy Disaster Relief Act Funds and Did Not Always Implement Effective Internal Controls Audit (A-02-15-02011)

03-17-2017

Data Inadequacies Undermine CMS's Oversight of the Inconsistency Resolution Process for the Federal Marketplace (OEI-01-14-00620)

03-15-2017

Updated Civil Monetary Penalties and Affirmative Exclusions

03-14-2017

Nantucket Cottage Hospital Did Not Accurately Report Certain Wage Data, Resulting in Overpayments to Massachusetts Hospitals (A-01-15-00502)

Public Summary Report: Information Technology Control Weaknesses Found at the Commonwealth of Massachusetts' Medicaid Management Information System (A-06-15-00057)

Hospitals Nationwide Generally Did Not Comply With Medicare Requirements for Billing Outpatient Right Heart Catheterizations With Heart Biopsies (A-01-13-00511)

03-13-2017

Medicare Compliance Review of University of Florida Health Jacksonville for 2013 and 2014 (A-04-15-07057)

Blue Cross Blue Shield Association Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2011 Through 2015 (A-07-17-00497)

Blue Cross Blue Shield Association Overstated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Assets as of September 30, 2015 (A-07-17-00496)

03-10-2017

Advisory Opinion 17-01 (regarding a hospital system's proposal to provide free or reduced-cost lodging and meals to certain financially needy patients)

Modification of Advisory Opinion 02-1 (modifies Advisory Opinion 02-1, which concerned a non-profit, tax-exempt, charitable organization's providing cost-sharing and premium assistance to financially needy patients diagnosed with specific chronic illnesses and rare disorders, to reflect guidance issued on May 21, 2014 in the Supplemental Special Advisory Bulletin regarding Independent Charity Patient Assistance Programs.)

03-09-2017

Testimony of Daniel R. Levinson, Inspector General, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Appropriations: Subcommittee on Labor, Health and Human Services, Education, and Related Agencies: "Management Challenges at the Departments of Labor, Health and Human Services, and Education and the Social Security Administration"

Review of Blue Cross Blue Shield Association Final Administrative Cost Proposals for Fiscal Years 2010 Through 2015 (A-05-15-00056)

Medicare Contractors' Payments to Providers for Hospital Outpatient Dental Services Generally Did Not Comply With Medicare Requirements (A-06-16-05003)

Nebraska Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Transportation Program (A-07-16-03209)

03-08-2017

Medicare Compliance Review of Mayo Clinic Florida for 2013 and 2014 (A-04-15-07058)

New York Improperly Claimed Federal Medicaid Reimbursement for Partial Hospitalization Services (A-02-16-01013)

Updated Provider Self-Disclosure Settlements

03-07-2017

LEIE Database Updated with February 2017 Exclusions and Reinstatements

Updated Corporate Integrity Agreement List

03-06-2017

Podcast: Medicaid Fraud Control Units

Medicaid Fraud Control Units Statistical Data for Fiscal Year 2016

• Data Chart
• Interactive Map

03-03-2017

Fraud Alert: HHS OIG Hotline Telephone Number Used in Scam

Video Series Eye on Oversight: Medical Identity Theft

03-01-2017

Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2016 (A-18-16-30350)

February

02-24-2017

Updated Corporate Integrity Agreement List: 1 CIA Added

02-23-2017

New Jersey Claimed Some Unallowable Costs Under a Hurricane Sandy Disaster Relief Act Grant (A-02-15-02005)

02-17-2017

Drug-Pricing and Reimbursement Portfolio

02-16-2017

Newark Preschool Council, Inc., Did Not Always Comply With Head Start Requirements (A-02-14-02024)

02-15-2017

New York Claimed Medicaid Reimbursement for Unallowable Dental Services Billed by a Dentist Based in Westchester County (A-02-13-01033)

New York Claimed Medicaid Reimbursement for Unallowable Dental Services Billed by a Dentist Based in Queens (A-02-13-01034)

02-14-2017

Updated Civil Monetary Penalties and Affirmative Exclusions

02-13-2017

The University of California at Riverside's Pilot Payroll Certification System Did Not Provide Accountability Over Payroll Charges to Federal Awards (A-04-13-01026)

02-08-2017

Puerto Rico's Controls for Its Child Care and Development Program Claims Were Not Effective (A-02-13-02005)

Updated Corporate Integrity Agreement List: 1 CIA Added

Updated Provider Self-Disclosure Settlements and CIA Reportable Event Settlements

02-07-2017

LEIE Database Updated with January 2017 Exclusions and Reinstatements

Updated Corporate Integrity Agreement List: 7 CIAs Closed

02-06-2017

HHS OIG's Podcast: Voluntary Tribal Compliance Agreement

Medicare Market Shares of Mail Order Diabetes Test Strips From July Through September 2016 (OEI-04-16-00471)

02-03-2017

CDC Awarded Selected Ebola Funds for International Response Activities in Accordance With Applicable Laws, Regulations, and Departmental Guidance (A-04-16-03568)

Kentucky Misallocated Millions to Establishment Grants for a Health Insurance Marketplace (A-04-14-07050)

Vidant Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition (A-03-15-00011)

02-02-2017

New Jersey Should Strengthen Hurricane Sandy Social Services Block Grant Internal Controls (A-02-14-02010)

02-01-2017

Fall Health Care Fraud and Abuse Legal Internship Program

January

01-31-2017

Testimony of Ann Maxwell, Assistant Inspector General, Office of Inspector General, U.S. Department of Health and Human Services: Medicaid Oversight: House Committee on Energy and Commerce: Subcommittee on Oversight and Investigations: "Existing Problems and Ways to Strengthen the Program"

Testimony of Vicki L. Robinson, Senior Counselor for Policy, Office of Inspector General, U.S. Department of Health and Human Services: House Committee on Oversight and Government Reform: Subcommittee on Health Care, Benefits, and Administrative Rules: "Fraud, Waste, and Abuse Under the Affordable Care Act"

01-30-2017

Updated Corporate Integrity Agreement List: 1 CIAs Added

01-26-2017

Review of California Medicaid Managed-Care Program Potential Savings With Minimum Medical Loss Ratio (A-09-15-02025)

01-25-2017

Updated Corporate Integrity Agreement List: 2 CIAs Added

01-23-2017

Excluded and Unlicensed New Jersey Dentist Who Assumed Identity of Another Dentist Agrees to Settlement of $1.1 Million and 50-Year Exclusion to Resolve Civil Monetary Penalty Case

Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2015 (A-18-16-30300)

Updated Corporate Integrity Agreement List: 1 CIA Added

01-19-2017

Independent Attestation Review: Indian Health Service Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00351)

Independent Attestation Review: National Institutes of Health Fiscal Year 2016 Detailed Accounting Submissions and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00352)

Independent Attestation Review: Substance Abuse and Mental Health Services Administration Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00353)

Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00354)

Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2016 Detailed Accounting Submission and Performance Summary Report for National Drug Control Activities and Accompanying Required Assertions (A-03-17-00355)

01-18-2017

FY 2016 Health Care Fraud and Abuse Control Program Report

Video Series Eye on Oversight: Exclusions

California Improperly Claimed Federal Medicaid Reimbursement for Certain Nonemergency Services (A-09-15-02020)

Northside Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition (A-03-15-00012)

A Southern California Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Therapy Services (A-09-15-02015)

Updated Civil Monetary Penalties and Affirmative Exclusions

01-13-2017

Updated Provider Self-Disclosure Settlements

01-12-2017

Louisiana Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Program (A-06-15-00019)

Delaware Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-03-15-00202)

01-11-2017

Final Rule: Health Care Programs: Fraud and Abuse; Revisions to the Office of Inspector General's Exclusion Authorities

01-10-2017

Podcast: December 2016 OIG Monthly Update

01-09-2017

Colorado Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-07-14-06050)

Medicare Compliance Review of NorthShore University HealthSystem for 2013 and 2014 (A-05-15-00044)

Updated Corporate Integrity Agreement List: 1 CIA Added

01-06-2017

LEIE Database Updated with December 2016 Exclusions and Reinstatements

Updated Corporate Integrity Agreement List: CIAs Added & Closed

01-05-2017

High-Price Drugs Are Increasing Federal Payments for Medicare Part D Catastrophic Coverage (OEI-02-16-00270)

Virginia Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-03-15-00201)

Medicare Compliance Review of Abbott Northwestern Hospital for 2013 and 2014 (A-05-15-00043)

01-03-2017

Updated Corporate Integrity Agreement List: 5 CIAs Added