Department of Health & Human Services

From October 1, 2011, through September 30, 2012, the California Department of Health Care Services claimed approximately $31,000 in unallowable enhanced Federal reimbursement for Medicaid family planning drugs and supplies in Los Angeles and Orange Counties. Some of this amount represented...

Group Health Incorporated, an Emblem Health Company, claimed unallowable pension costs of $1.2 million for Medicare reimbursement on its Incurred Costs Proposals for plan years 2007 and 2008.

In September 2013, nearly 1 year after Hurricane Sandy made landfall, the Substance Abuse and Mental Health Services Administration (SAMHSA) awarded $2.1 million in Disaster Relief Act funding to Link2Health Solutions, Inc. (L2HS), for the implementation and operation of the Sandy Helpline, which...

Not all of the salary and benefit expenses that the Rocky Boy Health Board (Rocky Boy), a component of the Chippewa Creek Tribe of the Rocky Boy's Reservation (Tribe), incurred were allowable in accordance with Federal requirements, the Tribe's policies, and Rocky Boy's policies. During Federal...

The Missouri Department of Social Services, Missouri HealthNet Division's (State agency) Medicaid payment rates for individualized supporting living (ISL) habilitation services provided and paid for during State fiscal years 2011 through 2013 were not always in accordance with Federal requirements...

Wisconsin Physicians Service's (WPS) (located in Madison, Wisconsin) payments to providers in Jurisdiction 5 (Iowa, Kansas, Missouri, and Nebraska) and Jurisdiction 8 (Indiana and Michigan) for hospital outpatient dental services generally did not comply with Medicare requirements. Of the 100 dental...

A physical therapist in Texas claimed Medicare reimbursement for outpatient physical therapy services that did not meet Medicare reimbursement requirements in calendar years 2012 and 2013. Specifically, of the 100 beneficiary claim days in our random sample, the therapist properly claimed Medicare...

Payments that the Medicare contractors for Jurisdiction E (which covers California, Hawaii, Nevada, and three Pacific territories) made to hospitals for 191 inpatient and outpatient claims for replaced cardiac medical devices did not comply with Medicare requirements for reporting manufacturer...

The Oregon Department of Human Services, Office of Licensing and Regulatory Oversight, verified nursing homes' correction of deficiencies identified during surveys in calendar year 2014 in accordance with Federal requirements.

Vermont Health Connect's (Vermont marketplace) internal controls were not always effective in ensuring that individuals were enrolled in qualified health plans (QHPs) according to Federal requirements. We identified deficiencies related to verifying applicants' identities, determining eligibility of...