Featured Topics

Below are compilations of OIG's existing work related to a specific subject matter area. They are updated as new material is published.

Cybersecurity: OIG recognizes Protecting HHS Data, Systems, and Beneficiaries from Cybersecurity Threats as a top management and performance challenge facing HHS. In partnering with various HHS agencies to address this challenge, OIG has formed a multidisciplinary Cybersecurity Team comprised of auditors, evaluators, investigators and attorneys focused on combatting cybersecurity threats within HHS and the healthcare industry.
The Emergency Medical Treatment and Labor Act (EMTALA): EMTALA is a federal law that imposes specific obligations on Medicare-participating hospitals that offer emergency services and requires that anyone coming to an emergency department requesting evaluation or treatment of a medical condition, receives a medical screening examination. If they have an emergency medical condition, the hospital must provide stabilizing treatment, regardless of the patient’s insurance status or ability to pay.
Managed Care: The growth of managed care over the last several years has changed fundamental aspects of the Medicare and Medicaid programs. This significant shift transformed how the government pays for and covers health care for approximately 100 million enrollees.
Adverse Events: Patients admitted to the hospital generally expect that the medical care they receive will improve their health, not worsen it. Unfortunately, that isn't always the case. In some instances, patients are harmed as a result of their medical treatment.
Information Blocking: On June 27, 2023, HHS-OIG posted its final rule implementing information blocking penalties. The final rule establishes the statutory penalties created by the 21st Century Cures Act. If OIG determines that an individual or entity has committed information blocking, they may be subject up to a $1 million penalty per violation.
Hospice: Hospice care is for terminally ill patients who decide to forgo curative treatment and instead receive palliative care. Years of OIG audits, evaluations, and investigations into hospice care have revealed that, while these services can provide great comfort to terminally ill patients and their families, there are significant problems with the program.
Telehealth: While the expansion of telehealth has been critical to maintaining beneficiaries' access to care, it is important that new policies and technologies with potential to improve care and enhance access achieve these goals and are not compromised by fraud, abuse, or misuse. OIG is conducting significant oversight work assessing telehealth services, including the impact of the public health emergency flexibilities.
Nursing Homes: OIG investigates potential violations to hold accountable those who victimize residents of nursing homes. Patient neglect and inadequate care by nursing facilities is a recurring challenge that OIG works with the Department of Justice to address in False Claims Act cases.
OIG Resources for Emergency Preparedness and Response: Learn key insights from OIG reports on preparedness and response efforts for emergency events including emerging infectious disease outbreaks, natural disasters, and bioterrorism.
Unaccompanied Children: HHS OIG has undertaken a body of work examining various aspects of the UAC program. For example, we have audited grantee expenditures and assessed their internal controls for administering UAC program funds. We also examined whether ORR grantees met safety standards for the care and release of children in their custody.
Coronavirus: The emergence of COVID-19 created unprecedented challenges for the Department of Health and Human Services (HHS) and for the delivery of health care and human services to those enrolled in Federal health care programs. HHS leads the Federal public health and medical response during public health emergencies. As the oversight agency for HHS, the Office of Inspector General (OIG) works to enhance the effectiveness of HHS's response and recovery efforts related to the pandemic. The information on this page highlights OIG's agency-wide work concerning COVID-19.
Natural Disaster Response: HHS OIG is one of many agencies the Federal Emergency Management Agency (FEMA) calls upon to respond to major disasters. As part of the Government's coordinated emergency response efforts, a team of OIG's special agents may deploy to provide leadership, equipment, expertise, security, and other support.
Combating the Opioid Epidemic: Addressing the opioid epidemic is a top priority for OIG. OIG's efforts fall in three areas: (1) identifying opportunities to improve the efficiency and effectiveness of HHS programs, (2) identifying and holding accountable those engaged in fraud (3) empowering and collaborating with partners through data sharing and education.
Group Homes: In response to media stories and a congressional request about abuse and neglect of developmentally disabled residents in group homes, OIG launched a series of audits that found that these residents often experienced serious injuries and medical conditions that resulted in emergency room visits. And we also found that up to 99 percent of these critical incidents were not reported to the appropriate law enforcement or state agencies, as required.
Affordable Care Act Reviews: OIG is focused on promoting the economy, efficiency, and effectiveness of Affordable Care Act (ACA) programs across HHS. We are conducting reviews of the health insurance marketplaces and related programs, as well as reviews of other health reform programs in Medicare, Medicaid, and the public health programs.
Drug Spending: For over 25 years, the HHS Office of Inspector General has conducted work to assess drug spending in HHS programs. This work covers three domains: reimbursement, program compliance, and incentive alignment. This page is a compilation of completed reports, unimplemented recommendations, enforcement actions, and industry guidance.
Hospital Compliance Reviews: These reviews are part of a series of hospital compliance reviews that focus on hospitals with claims that may be at risk for overpayments. Reviews began in 2011 and are ongoing.
Indian Health and Human Services: The Department of Health and Human Services (HHS) and its many agencies carry out health and human services programs for American Indians and Alaska Natives (AII/ANs) throughout the U.S. See an overview of the Office of Inspector General's (OIG) body of work as it relates to the Indian health and human services.
President's Emergency Plan for AIDS Relief (PEPFAR) Funds: President's Emergency Plan for AIDS Relief (PEPFAR) funds support international programs for acquired immunodeficiency syndrome (AIDS) prevention, treatment, and care. CDC received PEPFAR funds from the annual HHS appropriation and the Foreign Operations appropriation. See the PEPFAR reviews.