Department of Health & Human Services

This report provides a visual representation of data on the workload activities of Medicare benefit integrity contractors in calendar years 2012 and 2013. The report allows for a quick comparison of workload statistics across the 2 years, across contractors, and across Medicare programs and provides...

To bill for services they provide to beneficiaries, providers must enroll in Medicare and periodically revalidate this enrollment. Effective enrollment screening is an important tool in preventing Medicare fraud. The Centers for Medicare & Medicaid Services (CMS) has sought to enhance the enrollment...

The Office of Inspector General (OIG) oversees the activities of all Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. The reviews assess Unit performance in accordance with the 12...

Recent investigations by the Office of Inspector General have shown a number of instances in which hospices inappropriately billed Medicare for hospice general inpatient care (GIP). Misuse of GIP includes care being billed but not provided and beneficiaries receiving care they do not need. Such...

As required by the Affordable Care Act (ACA), HealthCare.gov is the Federal website that facilitates purchase of private health insurance for consumers who reside in States that did not establish health insurance marketplaces. At its launch on October 1, 2013, and for some time after, HealthCare.gov...

OIG oversees all State Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. The reviews assess Unit performance in accordance with the 12 MFCU performance standards and monitor Unit...

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based...

Long-term-care employees provide essential care to patients in settings such as nursing facilities, home health agencies, and hospices. Ensuring that these employees have undergone a minimum level of screening helps protect the safety of beneficiaries in these settings. The Patient Protection and...

The Office of Inspector General (OIG) administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of all Units...

The availability of child care after an emergency or disaster is an important part of recovery efforts because it ensures that children are safe while parents make efforts to rebuild their lives and communities. When Superstorm Sandy made landfall on October 29, 2012, it caused widespread flooding...