Department of Health & Human Services

During our audit period, Cahaba GBA was a subsidiary of Blue Cross and Blue Shield of Alabama (BCBS Alabama), whose home office is in Birmingham, Alabama. Cahaba GBA administered the Medicare Parts A and B Jurisdiction 10 MAC contract under cost reimbursement contracts with CMS. The Jurisdiction 10...

During our audit period, Cahaba GBA was a subsidiary of Blue Cross and Blue Shield of Alabama (BCBS Alabama), whose home office is in Birmingham, Alabama. Cahaba GBA administered the Medicare Parts A and B Jurisdiction 10 MAC contract under cost reimbursement contracts with CMS. The Jurisdiction 10...

The Centers for Medicare & Medicaid Services administers the Medicare program, which includes coverage for hospital outpatient services under Part B. Under the outpatient prospective payment system, Medicare pays for hospital outpatient services on a rate-per-service basis that varies according to...

Prior OIG work found that Medicare inappropriately paid for services that were billed as being distinct or significant and separately identifiable from other services provided on the same day. Our analysis showed that in 2018, an ophthalmology clinic in California (the Clinic) frequently billed for...

In recent years, Congress has expressed concerns about the Indian Health Service’s (IHS’s) administrative and financial management of program funds for health services to American Indians and Alaska Natives. Before we could address Congress’ broader concerns, we needed to assess how the 12 IHS Area...

The U.S. 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...