Department of Health & Human Services

A Kansas physical therapy practice (the Therapy Practice) claimed Medicare reimbursement for some outpatient physical therapy services that did not meet Medicare reimbursement requirements. Of the 100 beneficiary days in our random sample, the Therapy Practice properly claimed Medicare reimbursement...

Although the Kansas Department of Health and Environment, Division of Health Care Finance (State agency) generally complied with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs dispensed to enrollees of Medicaid managed-care organizations (MCOs)...

Home Health VNA (the Agency) (located in Lawrence, Massachusetts) did not comply with Medicare billing requirements for 105 of the 497 home health claims we reviewed. As a result, the Agency received net overpayments of $314,000 for calendar years 2011 and 2012. Specifically, the Agency incorrectly...

The Cybersecurity Act of 2015 (Cybersecurity Act) requires the Inspector General of each covered agency to collect and report to Congress information about the covered agency's covered systems within 240 days of the enactment of the Cybersecurity Act. A covered agency is an agency that operates a...

During our audit of the Alabama Medicaid Agency's (State agency) hospital certified public expenditures (CPEs) program for fiscal year (FY) 2010, we noticed that the State agency had claimed, for FYs 2010 and 2011, more than $5 million in Federal funds related to CPEs for three hospitals that...

Under the Children's Health Insurance Program Reauthorization Act of 2009, Congress appropriated $3.225 billion for qualifying States to receive performance bonus payments (bonus payments) for Federal fiscal years (FYs) 2009 through 2013 to offset the costs of increased enrollment of children in...

From January 1, 2011 to June 30, 2014, the Pennsylvania Department of Health and Human Resources, Department of Medical Assistance Services (the State agency), made approximately $287.4 million for Medicaid Electronic Health Record incentive payments. Of this amount, $158.1 million was paid to 136...

From July 1, 2011, through December 31, 2013, the West Virginia Department of Health and Human Resources, Department of Medical Assistance Services (the State agency) paid $50.3 million to 42 eligible hospitals in West Virginia for Medicaid electronic health record (ERD) incentive payments. We...

A chiropractic clinic based in Michigan (Michigan Chiropractor) did not comply with Medicare billing requirements for 100 chiropractic service line items that we sampled. Specifically, the medical records did not support the medical necessity for 92 of the 100 sampled chiropractic services. On the...

The Texas Health and Human Services Commission (State agency) did not always calculate supplemental payments made to the University of Texas (UT) health institutions in accordance with Federal and State requirements. Specifically, the supplemental payment calculations included overstated Medicare...