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Indian Health and Human Services

This webpage offers an overview of the Office of Inspector General's (OIG) body of work as it relates to the Indian health and human services.

Planned Work

  • Maternal mortality and morbidity are increasing in the United States, and up to 60 percent of maternal deaths may be preventable. The American College of Obstetricians and Gynecologists issues guidance on safe practices during labor and delivery intended to help reduce maternal mortality and other complications. Read the Work Plan Summary

  • Details surrounding the recent conviction of a former Indian Health Service (IHS) physician for patient abuse raised concerns about IHS policies and procedures to prevent and address patient abuse. Read the Work Plan Summary

  • Office of Evaluation and Inspections OEI-05-18-00470 2020 Opioid abuse and overdose deaths are at crisis levels in the United States, with approximately 49,000 Americans dying from opioids in 2017, an increase from more than 42,000 in 2016. Consistent with previous OIG work in Medicare Part D and Medicaid, we will determine the extent to which beneficiaries are receiving extreme amounts of opioids through Indian Health Service (IHS), as well as IHS-employed prescribers and IHS-run pharmacies that have questionable prescribing or dispensing patterns. This review will also determine how IHS prevents and detects opioid misuse or abuse, as well as how it enforces its opioid-related policies. Read the Work Plan Summary

  • IHS provides a comprehensive health service delivery system for approximately 2 million American Indians and Alaska Natives either by operating health facilities directly or by funding tribes through contracts or compacts to operate health facilities themselves. In certain cases, tribes may operate a facility known as a Federally Qualified Health Center (FQHC), which is certified by CMS to provide outpatient health services to rural areas or underserved populations. In addition to funding from IHS, the tribes may also receive health care funding from the Medicaid or Medicare programs. This report will build on OIG’s body of work identifying longstanding challenges that likely impact the quality of health care services provided to American Indians and Alaska Natives. We will review a tribally operated FQHC that is funded by IHS, to determine whether health services delivered to American Indians and Alaska Natives met applicable Federal requirements. Read the Work Plan Summary

  • IHS directly operates 28 hospitals, 62 health centers, and 25 health stations with dispersed management. We will examine the management of IHS, including assessing the organizational framework of IHS headquarters operations. This will include reviewing the fulfillment of roles and responsibilities, enforcement of policies and procedures, and strategies to address current and future challenges. We will conduct interviews with senior management responsible for policies, practices, and resources that support care delivery in IHS facilities. Read the Work Plan Summary

Related Reports

Report Date
Case Study: Indian Health Service Management of Rosebud Hospital Emergency Department Closure and Reopening (OEI-06-17-00270) 07/17/2019
IHS Needs To Improve Oversight of Its Hospitals' Opioid Prescribing and Dispensing Practices and Consider Centralizing Its Information Technology Functions (A-18-17-11400) 07/17/2019
The Passamaquoddy Tribe's Pleasant Point Health Center Needs To Improve Its Medical-Referral Process (A-01-17-01503) 03/29/2019
The Penobscot Indian Nation Did Not Meet All Federal and Tribal Health and Safety Requirements (A-01-17-01502) 11/26/2018
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) 08/21/2018
The Passamaquoddy Tribe's Pleasant Point Health Center Did Not Always Meet Federal and Tribal Health and Safety Requirements (A-01-17-01500) 07/30/2018
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) 07/05/2018
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) 04/12/2018
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) 09/27/2017
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) 12/14/2017
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) 11/28/2017
The Three Affiliated Tribes Improperly Administered Low-Income Home Energy Assistance Program Funds for Fiscal Years 2010 Through 2014 (A-07-16-04230) 07/13/2017
Indian Health Service Hospitals: More Monitoring Needed to Ensure Quality Care (OEI-06-14-00010) 10/6/2016
Indian Health Service Hospitals: Longstanding Challenges Warrant Focused Attention to Support Quality Care (OEI-06-14-00011) 10/6/2016
Expenses Incurred by the Rocky Boy Health Board Were Not Always Allowable or Adequately Supported (A-07-15-04221) 3/22/2016
OIG Site Visits to Indian Health Service Hospitals in the Billings, Montana Area (OEI-09-13-00280) 8/14/2015
Access to Mental Health Services at Indian Health Service and Tribal Facilities (OEI-09-08-00580) 9/30/2011
Access to Kidney Dialysis Services at Indian Health Service and Tribal Facilities (OEI-09-08-00581) 9/30/2011
Audit of the Indian Health Service’s Internal Controls Over Monitoring of Recipients’ Compliance With Requirements of the Loan Repayment Program (A-09-10-01005) 12/29/2010
Results of Limited Scope Review of Sisseton-Wahpeton Oyate Head Start Program (A-07-09-03134) 6/15/2010
Results of Limited Scope Review at the Confederated Tribes and Bands of the Yakama Nation's Head Start Program (A-09-09-00099) 3/2/2010
Audit of the Mashantucket Pequot Tribal Nation's Use of Federal Discount Drug Programs (A-01-99-01502) 8/17/2000