Department of Health & Human Services

The purpose of this review was to identify and address factors that contributed to the Hawaii Medicaid Fraud Control Unit's (MFCU's or Unit's) low case outcomes during federal fiscal years (FYs) 2016-18 and to assess Unit operations. In 2015, OIG issued a report from its 2014 onsite review of the...

This report fulfills for 2020 the annual reporting mandate from the Patient Protection and Affordable Care Act (ACA). The ACA requires OIG to conduct a study of the extent to which formularies used by Medicare Part D plans include drugs commonly used by full benefit dual eligible individuals (i.e...

This memorandum report presents performance data for the Senior Medicare Patrol (SMP) projects, which receive grants from ACL to recruit and train retired professionals and other older adults and community members to recognize and report instances or patterns of health care fraud. OIG has collected...

The Department of Health and Human Services (HHS), Administration for Children and Families (ACF), Office of Refugee Resettlement (ORR), has custody of and must provide care to minors (children younger than 18 years of age) in the Unaccompanied Alien Children (UAC) Program. ORR is responsible for...

Protecting children in the Unaccompanied Alien Children (UAC) Program is an essential and ongoing responsibility of the Office of Refugee Resettlement (ORR). By law, ORR, which is within the Department of Health and Human Services' ACF, has custody of and must provide care for each child in the UAC...

Medicaid telemedicine services are health services delivered via telecommunication systems. A Medicaid patient located at a patient site uses audio and video equipment to communicate with a physician or licensed practitioner located at a distant site. Medicaid views telemedicine services as a cost...

This audit is part of a series of hospital compliance audits. Using computer matching, data mining, and data analysis techniques, we identified hospital claims that were at risk for noncompliance with Medicare billing requirements. For calendar year 2017, Medicare paid hospitals $206 billion, which...

Due to the current public health emergency and increased cyber-activity, we are only posting the title of our cybersecurity audits.

New Jersey pays managed care organizations (MCOs) to make managed long-term services and supports (MLTSS) available to Medicaid beneficiaries in home and community-based settings. Recent OIG audits of Medicaid home and community-based and managed long-term-care services identified significant...

The Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019, and Continuing Appropriations Act, 2019, P.L. No. 115-245, directed OIG to examine the efforts of the National Institutes of Health (NIH) to ensure the integrity of its grant application...