Department of Health & Human Services

New York established a health insurance marketplace under the provisions of the Patient Protection and Affordable Care Act to allow individuals and small businesses to shop for health insurance. The New York marketplace provides eligibility determination and enrollment services for both private...

During fiscal year 2015, the National Institutes of Health (NIH) did not always administer Superfund appropriations in accordance with applicable Federal requirements. NIH generally obligated and disbursed Superfund appropriations; however, NIH had not (1) always ensured that Superfund grantees...

The Health Resources and Services Administration (HRSA) awarded Henry J. Austin Health Center, Inc. (HJAHC), a not-for-profit organization, $8.3 million in grant funds through several Community Health Center Program grants to provide comprehensive primary care services in the Trenton, New Jersey...

The Administration for Children and Families (ACF) had a process in place to ensure that Head Start grantees took corrective action on A-133 audit findings. Head Start grantees are required to have Single Audits conducted in accordance with Office of Management and Budget Circular A 133 (also known...

Home health is a program area susceptible to fraud, waste, and abuse. To ensure that home health agencies (HHAs) comply with Medicare standards, Medicare requires them to undergo onsite surveys conducted by State survey agencies or accrediting organizations prior to initial enrollment and at least...

The Patient Protection and Affordable Care Act gave States the option to expand Medicaid coverage to low-income adults without dependent children. It also mandated changes to Medicaid eligibility rules and established a higher Federal reimbursement rate for services provided to these beneficiaries...

For the grant we reviewed, Association for Public Health Laboratories managed Global Health Security Agenda funds during the budget period July 1, 2015 through June 30, 2016, in accordance with Federal requirements. Accordingly, this report contains no recommendations.

Memorial University Medical Center complied with Medicare billing requirements for 92 of the 131 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 39 claims, resulting in overpayments of $599,530.

Payments made to providers for specimen validity tests did not comply with Medicare billing requirements. Specifically, Medicare improperly paid 4,480 clinical laboratories and physician offices a total of $66.3 million for specimen validity tests billed in combination with urine drug tests. Centers...

When Arizona billed manufacturers for rebates for pharmacy and physician-administered drugs, it did so correctly. However, Arizona did not bill for and collect from manufacturers estimated rebates of $36.7 million ($25.6 million Federal share) for physician-administered drugs. For drugs that were...