Department of Health & Human Services

The House Committee on Energy and Commerce's Subcommittee on Oversight and Investigations and Subcommittee on Health requested that the U.S. Department of Health and Human Services, Office of Inspector General, provide information regarding the Centers for Medicare & Medicaid Services' (CMS)...

Arkansas did not always make the supplemental Medicaid payments in accordance with Federal requirements. Sixteen of the 120 supplemental payments in our stratified random sample were correct. For 88 of the remaining 104 supplemental payments, Arkansas incorrectly calculated the amount of the...

On the basis of our review of 100 sampled deficiencies, we determined that the Kansas Department of Aging and Disability Services, Survey, Certification and Credentialing Commission (State agency), did not always verify nursing homes' correction of deficiencies identified during surveys in calendar...

HHS oversees States' use of various Federal programs, including Medicaid. State agencies are required to establish appropriate computer system security requirements and conduct biennial reviews of computer system security used in the administration of State plans for Medicaid and other Federal...

Companion Data Services, LLC, overstated the Medicare segment pension assets by $118,000 from January 1, 2008, to January 1, 2013.

Companion Data Services, LLC, understated its allocable pension costs by $30,000 for calendar years 2008 through 2012.

Blue Cross Blue Shield of South Carolina overstated its allocable pension costs by $6.2 million for calendar years 2006 through 2012.

Medicare Part B paid for some immunosuppressive drugs billed with the KX modifier that were not eligible for Part B payment. Of the 75 claims in our random sample, pharmacies had documentation to support the KX modifier for 65 claims but did not have support for the remaining 10.

Several of the Consumer Operated and Oriented Plans (CO-OPs) that were operating at the beginning of 2016 are no longer viable or sustainable. Specifically, 5 of the 11 CO-OPs operating on January 1, 2016, had ceased or planned to cease operations by the end of the 2016 plan year, and each of the...

This memorandum alerts the Centers for Medicare & Medicaid Services (CMS) to the preliminary results of our ongoing review of potential abuse or neglect of Medicare beneficiaries in skilled nursing facilities (SNFs). This audit is part of the ongoing efforts of the Office of Inspector General (OIG)...