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Source Id
395

Accredo Health Group, Inc., Properly Billed Medicare for Inhalation Drugs 

2017
A-09-16-02022
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Accredo Health Group, Inc. (which is located in Memphis, Tennessee, and has pharmacies across the United States) complied with Medicare requirements when billing for inhalation drugs. Specifically, all 100 claim lines in our sample complied with the requirements. Consequently, this report has no...

Fox Rehabilitation Claimed Unallowable Medicare Reimbursement for Outpatient Therapy Services 

2017
A-02-16-01004
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Medicare Part B provides for the coverage of outpatient therapy services, including occupational, physical, and speech therapy. Previous OIG reports identified unallowable claims for these services. Fox Rehabilitation (Fox), headquartered in New Jersey, was among the largest providers of outpatient...

Kentucky Did Not Always Perform Medicaid Eligibility Determinations for Non-Newly Eligible Beneficiaries in Accordance With Federal and State Requirements 

2017
A-04-16-08047
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Kentucky did not always determine Medicaid eligibility in accordance with Federal and State requirements. For our sample of 120 beneficiaries, Kentucky correctly determined eligibility for 113 beneficiaries, but it did not meet Federal and State requirements for eligibility determinations of 7...

Public Summary Report: The State of North Carolina Did Not Ensure That Federal Information System Security Requirements Were Met for Safeguarding Its Medicaid Claims Processing Systems and Data 

2017
A-07-16-00469
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

HHS oversees States' administration 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...

Texas Improperly Received Medicaid Reimbursement for School-Based Health Services 

2017
A-06-14-00002
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Not all of the direct medical service costs that the Texas Health and Human Services Commission (State agency) claimed for Medicaid School Health and Related Services (SHARS) were reasonable, adequately supported, and otherwise allowable in accordance with applicable Federal and State requirements...

TrailBlazer Health Enterprises, LLC, Claimed Some Unallowable Medicare Administrative Contract Pension Costs 

2017
A-07-17-00510
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

TrailBlazer Health Enterprises, LLC, claimed $228,000 of unallowable Medicare pension costs on its Incurred Cost Proposals for calendar years 2008 through 2013.

The Ministry of Health and Social Welfare National AIDS Control Program Did Not Always Manage and Expend PEPFAR Funds in Accordance With Award Requirements 

2017
A-04-16-04044
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Congress authorized the President's Emergency Plan for AIDS Relief (PEPFAR) to receive $48 billion in funding for the 5-year period beginning October 1, 2008, to assist foreign countries in combating HIV/AIDS, tuberculosis, and malaria. Congress authorized additional funds to be appropriated through...

Public Summary Report: Information Technology Control Weaknesses Found in the New Mexico Human Services Department's Medicaid Eligibility Systems 

2017
A-06-16-05000
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

This summary report provides an overview of the results of our audit of the information system general controls over the New Mexico Medicaid eligibility systems. It does not include specific details of the vulnerabilities that we identified because of the sensitive nature of the information. We have...

Maine Did Not Comply With Federal and State Requirements for Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities 

2017
A-01-16-00001
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Maine Department of Health and Human Services (State agency) did not comply with Federal Medicaid waiver and State requirements for reporting and monitoring critical incidents involving Medicaid beneficiaries with developmental disabilities residing in community residences. The State agency did...

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