Department of Health & Human Services

Louisiana did not comply with Federal and State requirements prohibiting Medicaid payments for inpatient hospital services related to treating certain provider-preventable conditions (PPCs) because it did not have controls to identify claims with PPCs that would have required a reduction in claim...

Medicare covers nonemergency ambulance transportation when furnished to a beneficiary whose medical condition is such that other means of transportation could endanger the beneficiary's health. Medicare paid Midwood Ambulance & Oxygen Service, Inc. (Midwood), an ambulance company in Brooklyn, New...

Ohio made capitation payments totaling $90.5 million on behalf of deceased beneficiaries. We confirmed that all beneficiaries associated with the 100 capitation payments in our stratified random sample were deceased. Ohio properly recovered 37 of these capitation payments. However, Ohio did not...

The Centers for Medicare & Medicaid Services (CMS) Enrollment Database (EDB) is the primary source of Medicare enrollment information for the entire population of beneficiaries who have ever received Medicare benefits. Based on CMS officials’ estimates, we calculated the daily financial impact of a...

Heartland Human Care Services, Inc. (Heartland), generally met applicable safety standards for the care and release of children in its custody. Heartland met State licensure requirements and requirements for inspections, performed adequate oversight, and followed guidance when reviewing background...

The Passamaquoddy Tribe at Pleasant Point did not always meet Federal requirements for medical referrals. Specifically, we found that the Pleasant Point Health Center (PPHC) did not utilize a Managed Care Committee (MCC), composed of the required medical and administrative staff, to review medical...

State Medicaid agencies and their contractors maintain and process health information for millions of beneficiaries. Prior OIG reviews have identified vulnerabilities in States' information systems and controls-vulnerabilities that could have resulted in unauthorized disclosure of protected health...

The Department of Health and Human Services (HHS) is the lead Federal agency responsible for medical support and coordination during public health emergencies. In 2014, the domestic outbreak of Ebola virus disease (Ebola) tested U.S. hospitals' ability to respond to a serious infectious disease...

National Government Services, Inc., properly updated the Plan B Medicare segment pension assets from January 1, 2011, through January 1, 2015.

TrustSolutions, LLC, properly updated the Medicare segment pension assets from January 1, 2010, to December 31, 2012.