Department of Health & Human Services

The Inspector General Act of 1978 (Public Law 95-452), as amended, requires that the Inspector General report semiannually to the head of the Department and the Congress on the activities of the office during the 6-month periods ending March 31 and September 30. The semiannual reports are intended...

This spring edition of the Semiannual Report to Congress covers OIG activities from October 2016 through March 2017. Historically, about 80 percent of OIG's resources are directed to work related to Medicare and Medicaid. This is mirrored in the organization and content of the report.

The California Department of Social Services (Social Services), Community Care Licensing Division (licensing division), did not (1) accurately record or investigate one complaint, (2) complete investigations in a timely manner, (3) refer priority I and II complaints (the most serious) to the...

Integrated Health Administrative Services, Inc. (Integrated), (located in Mamaroneck, New York) complied with certain Medicare Part B requirements for 91 of the 112 claims that we sampled. However, the remaining 21 claims did not comply with certain Medicare requirements. On the basis of our sample...

Federal regulations require each State to ensure that Medicaid beneficiaries have necessary transportation to and from medical providers. During the period October 1, 2012, through September 30, 2013, the Minnesota Department of Human Services (State agency) claimed at least $6.4 million for...

The Massachusetts Department of Children and Families (State agency) generally complied with applicable Federal and State regulations for ensuring that children who were Title IV-E eligible and residing in foster care congregate care group homes received medical services during calendar year 2015 as...

Medicare Compliance Review of Parkridge Medical Center, Inc., for 2014 and 2015 Parkridge Medical Center, Inc. (the Hospital), located in Chattanooga, Tennessee, complied with Medicare billing requirements for 88 of 100 inpatient claims we reviewed. However, the Hospital did not fully comply with...

The summarized results of our individual Medicare contractor reviews (issued between June 2014 and September 2015) revealed that for the period October 2003 through March 2011, Medicare contractors did not always refer Medicare cost reports that qualified for reconciliation, and the Centers for...

The Centers for Medicare & Medicaid Services (CMS) oversees implementation of health insurance provisions for the Affordable Care Act and works with States to establish marketplaces, which evaluate individuals' eligibility for qualified health plans (QHPs) and insurance affordability programs (i.e...

Although the Oklahoma Department of Human Services (State agency) performed the required onsite monitoring at all 22 group homes, this onsite monitoring did not ensure that foster care group homes complied with State licensing and Federal requirements related to the health and safety of children in...