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Source Id
395

First Coast Service Options, Inc., Did Not Claim Some Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals

2018
A-07-18-00536
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

First Coast Service Options, Inc., did not claim $1.06 million of allowable Medicare Supplement Executive Retirement Plan costs for calendar years 2008 through 2010.

CMS Did Not Always Provide Accurate Medicaid Unit Rebate Offset Amounts to State Medicaid Agencies

2018
A-07-17-06074
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Centers for Medicare & Medicaid Services (CMS) did not always provide accurate Medicaid unit rebate offset amounts (UROAs) to State Medicaid agencies (State agencies) during the period January 1, 2010, through December 31, 2014, in accordance with Federal guidance. (Under the Medicaid drug...

Iowa Complied With Most Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions

2018
A-07-17-03221
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Iowa Department of Human Services (State agency) complied with most Federal requirements prohibiting Medicaid payments for inpatient hospital services related to treating certain provider-preventable conditions (PPCs), because its automated system edits identified claims submitted by the...

Missouri Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions

2018
A-07-16-03216
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Missouri Department of Social Services (State agency) did not comply with Federal and State requirements prohibiting Medicaid payments for inpatient hospital services related to treating certain provider-preventable conditions (PPCs), which are certain reasonably preventable conditions caused by...

Medicare Improperly Paid Providers for Nonemergency Ambulance Transports to Destinations Not Covered by Medicare

2018
A-09-17-03018
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Medicare made improper payments of $8.7 million to providers for nonemergency ambulance transports to destinations not covered by Medicare, including the identified ground mileage associated with the transports. Medicare covers ambulance transports to only certain destinations, such as hospitals...

Setting Medicare Payment Rates for Clinical Diagnostic Laboratory Tests: Strategies To Ensure Data Quality

2018
OEI-09-17-00050
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

The Protecting Access to Medicare Act of 2014 (PAMA) reformed the way the Medicare program sets payment rates for clinical diagnostic laboratory tests (lab tests) under Part B. CMS's new rates, which took effect on January 1, 2018, are based on lab-reported data: rates paid by private payers such as...

The Administration for Children and Families Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements

2018
A-07-17-03225
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The U.S. Department of Health and Human Services (HHS), Administration for Children and Families (ACF), did not always resolve audit recommendations in a timely manner during Federal fiscal years (FYs) 2015 and 2016. Specifically, ACF resolved 1,570 of the 2,248 audit recommendations that were...

Some New York City Childcare Providers Did Not Always Comply With Health and Safety Requirements

2018
A-02-16-02003
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

New York did not ensure that selected New York City providers (operating in Brooklyn, NY) that received funding from the Child Care and Development Fund complied with applicable State and local requirements related to the health and safety of children. We found potentially hazardous physical...

University of Wisconsin Hospitals and Clinics Authority Incorrectly Billed Medicare Inpatient Claims With Severe Malnutrition

2018
A-03-17-00005
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Nutritional Marasmus and other/unspecified severe protein-calorie malnutrition are two types of severe malnutrition listed in the International Classification of Diseases, Clinical Modification. Previous OIG reviews have determined that hospitals incorrectly billed for Kwashiorkor, a third type of...

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