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Source Id
395

New York's Oversight of Medicaid Managed Care Organizations Did Not Ensure Providers Complied With Health and Safety Requirements at 18 of 20 Adult Day Care Facilities Reviewed

2020
A-02-18-01027
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

In New York, adult day care facilities provide functionally impaired adults with socialization, supervision and monitoring, and nutrition services in a protective setting. Beneficiaries enrolled in New York's Medicaid managed long-term-care program receive adult day care services from providers...

The National Institutes of Health Has Controls to Mitigate the Risk That Grantees Receive Duplicate Grant Funding

2020
A-02-19-02002
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

This audit is part of a larger body of Congressionally directed work to conduct oversight of National Institutes of Health (NIH) grant programs and operations. OIG was directed to examine NIH's oversight of its grantees' compliance with NIH policies, including NIH efforts to ensure the integrity of...

Missouri Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness

2020
A-07-18-03230
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

In 2016, the Centers for Medicare & Medicaid Services (CMS) updated its life safety and emergency preparedness regulations to improve protections for all Medicare and Medicaid beneficiaries, including those residing in long-term-care facilities (commonly referred to as nursing homes). Updates...

States' Use of Grant Funding for a Targeted Response to the Opioid Crisis

2020
OEI-BL-18-00460
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

To address the increased need for treatment services, the 21st Century Cures Act established the State Targeted Response to the Opioid Crisis grant program (STR grant program). Through this program, SAMHSA awarded almost $1 billion in grants to States over a 2-year grant period (May 2017 through...

CMS Could Take Actions To Help States Comply With Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions

2020
A-09-18-02004
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Provider-preventable conditions (PPCs) are certain reasonably preventable conditions caused by medical accidents or errors in a healthcare setting. In 2011, the Centers for Medicare & Medicaid Services (CMS) issued Federal regulations prohibiting Federal Medicaid payments for services related to...

Communication and Management Challenges Impeded HHS's Response to the Zero-Tolerance Policy

2020
OEI-BL-18-00510
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

In spring 2018, the Department of Justice and Department of Homeland Security (DHS) adopted a zero-tolerance policy under which large numbers of families entering the United States without authorization were separated by DHS.

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2019

2020
OEI-03-20-00040
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

When Congress established average sales price (ASP) as the basis for Medicare Part B drug reimbursement, it also provided a mechanism for monitoring market prices and limiting potentially excessive payment amounts.

Florida Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness

2020
A-04-18-08065
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

In 2016, the Centers for Medicare & Medicaid Services (CMS) updated its life safety and emergency preparedness regulations to improve protections for all Medicare and Medicaid beneficiaries, including residents of long-term-care facilities (commonly referred to as nursing homes). Updates included...

Key Medicare Tools To Safeguard Against Pharmacy Fraud and Inappropriate Billing Do Not Apply to Part D

2020
OEI-02-15-00440
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

Medicare Part D paid $168 billion for drugs for 46.8 million Medicare beneficiaries in 2018. Despite its size, Part D does not have the same protections against pharmacy fraud that other parts of Medicare have.

SAMHSA's Oversight of Accreditation Bodies for Opioid Treatment Programs Did Not Comply With Some Federal Requirements

2020
A-09-18-01007
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Substance Abuse and Mental Health Services Administration (SAMHSA) estimated that, in 2017, 1.7 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers.

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