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Source Id
395

Bayview Nursing and Rehabilitation Center Claimed Allowable Hurricane Sandy Disaster Relief Act Funds 

2016
A-02-15-02010
Disaster Recovery Report
Department of Health & Human Services OIG
Department of Health & Human Services

The New York State Office of Children and Family Services awarded approximately $2.8 million of Disaster Relief Act funds to Bayview Nursing and Rehabilitation Center (Bayview) for construction and equipment expenses resulting from Hurricane Sandy.

Wyoming Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs 

2016
A-07-15-06063
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Wyoming Department of Health, Division of Healthcare Financing (State agency), did not always comply with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs. The State agency did not invoice manufacturers for rebates associated with $2.6...

Medicare Compliance Review of Saint Louis University Hospital for 2011 and 2012 

2016
A-07-14-05066
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Saint Louis University Hospital (the Hospital) (operating in Saint Louis, Missouri) complied with Medicare billing requirements for 243 of the 261 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 18 claims...

Cornerstone Hospital of Bossier City Incorrectly Billed Medicare Inpatient Claims with Kwashiorkor 

2016
A-03-15-00006
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Cornerstone Hospital of Bossier City (The Hospital), in Bossier City, Louisiana, did not comply with Medicare requirements for billing Kwashiorkor on any of the 73 claims that we reviewed. The Hospital used diagnosis code 260 for Kwashiorkor but should have billed for other forms of malnutrition...

First Coast Service Options’ Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction N Generally Did Not Comply With Medicare Requirements 

2016
A-06-15-00013
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The payments that First Coast Service Options (FCSO) made to providers in Jurisdiction N (Florida, Puerto Rico, and the U.S. Virgin Islands) for hospital outpatient dental services generally did not comply with Medicare requirements. Of the 100 dental services in our stratified random sample, 95 did...

Opportunities for Program Improvements Related to States' Withdrawals of Federal Medicaid Funds 

2016
A-06-14-00068
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Centers for Medicare & Medicaid Services (CMS) has not issued guidance instructing States on the appropriate extent and timing of Medicaid withdrawals. Specifically, CMS has not issued guidance that clarifies the "as needed" language in 42 CFR § 430.30(d)(3) that would educate States on the...

South Carolina Generally Claimed Costs on Behalf of Wateree Community Actions, Inc., That Were in Accordance With the Grants and Applicable Federal Regulations, but Wateree Mismanaged Federal Funds 

2016
A-04-14-04026
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

For fiscal years (FYs) 2012 and 2013, the South Carolina Office of Economic Opportunity (State agency) claimed costs on behalf of Wateree Community Actions, Inc. (Wateree), for Community Services Block Grant (CSBG) and Low-Income Home Energy Assistance Program (LIHEAP) grants that were allowable...

Some Florida Family Childcare Homes Did Not Always Comply With State Health and Safety Requirements 

2016
A-04-14-08034
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Florida Office of Early Learning (State lead agency) or counties did not always ensure that providers that received funding from the Child Care and Development Fund (CCDF) complied with State requirements related to the health and safety of children. Specifically, of the 20 providers we selected...

Some Florida Childcare Centers Did Not Always Comply With State Health and Safety Licensing Requirements 

2016
A-04-14-08033
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Although the Florida Department of Children and Families (State licensing agency) or county conducted the required inspections at the four providers that we reviewed, this onsite monitoring did not ensure that providers that received funds from the Child Care and Development Fund complied with State...

North Carolina Did Not Always Make Correct Medicaid Claim Adjustments 

2016
A-04-14-00100
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The North Carolina Division of Medical Assistance (State agency) did not always use the correct Federal medical assistance percentages (FMAPs) when processing claim adjustments reported to the Centers for Medicare & Medicaid Services. Of the 9.2 million claims we reviewed, the State agency processed...

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