Department of Health & Human Services

We reviewed the oversight of opioid prescribing and the monitoring of opioid use in Nevada. This factsheet shows Nevada's responses to our questionnaire covering five categories related to its approach to addressing the opioid epidemic: policies and procedures, data analytics, programs, outreach...

Of the $374 million in managed care organization (MCO) recoveries, New Mexico appropriately refunded the Federal share for $359 million. However, New Mexico underreported the Federal share for the remaining $15 million by $4.4 million because (1) it incorrectly calculated the Federal share of...

The Missouri Department of Social Services (State agency) claimed Federal Medicaid reimbursement of at least $6 million (almost $3.8 million Federal share) for unallowable targeted case management (TCM) payments during Federal fiscal years 2014 and 2015. The State agency paid TCM providers and...

When Congress established average sales price (ASP) as the basis for Medicare Part B drug reimbursement, it also provided a mechanism for monitoring market prices and limiting potentially excessive payment amounts. The Social Security Act (the Act) mandates that OIG compare ASPs with average...

According to Federal law, to be eligible for coverage of posthospital extended care services, a Medicare beneficiary must be an inpatient in a hospital for not less than 3 consecutive calendar days (3-day rule) before being discharged from the hospital. CMS improperly paid 65 of the 99 skilled...

The U.S. Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC), did not always resolve audit recommendations in a timely manner during Federal fiscal years (FYs) 2015 and 2016. Specifically, CDC resolved 855 of the 888 audit recommendations that were...

We reviewed the oversight of opioid prescribing and the monitoring of opioid use in New Hampshire. This factsheet shows New Hampshire's responses to our questionnaire covering five categories related to its approach to addressing the opioid epidemic: policies and procedures, data analytics, programs...

We reviewed the oversight of opioid prescribing and the monitoring of opioid use in the State of Nebraska. This factsheet shows the State of Nebraska's responses to our questionnaire covering five categories related to its approach to addressing the opioid epidemic: policies and procedures, data...

Prior OIG reviews identified significant Medicare Part B overpayments, including those to ambulance suppliers, for services they provided to Medicare beneficiaries during skilled nursing facility (SNF) stays covered under Medicare Part A. The Centers for Medicare & Medicaid Services (CMS) generally...

State survey agencies (State agencies) must verify that nursing homes corrected identified deficiencies, such as the failure to provide necessary care and services, before certifying whether the nursing homes are in substantial compliance with Federal participation requirements for Medicare and...