Department of Health & Human Services

Pennsylvania did not ensure that its managed-care organizations complied with Federal and State requirements prohibiting Medicaid payments to providers for inpatient hospital services related to treating certain provider-preventable conditions. For our audit period, we identified that managed-care...

In June 2017, HHS-OIG received a hotline complaint alleging that the Administration for Community Living (ACL) was not conducting its required oversight of independent living programs. We performed this audit to determine whether ACL appropriately oversaw the activities of independent living...

The Child Care and Development Fund (CCDF) program, for which fiscal year (FY) 2018 Federal funding totaled $8.2 billion, provides child care subsidies for 1.4 million eligible children. CCDF program payments, which are administered by States, allow eligible low income parents to work or pursue...

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. The Social Security Act (the Act) mandates that OIG compare ASPs with average...

Effective June 1, 2006, Georgia implemented Georgia Families, a managed care program between Georgia and private health plans to provide benefits and health care services to Medicaid, PeachCare for Kids members, Planning for Healthy Babies enrollees, and Georgia Families 360° members. As of July...

According to the Centers for Disease Control and Prevention (CDC), opioids were involved in more than 47,000 deaths in 2017, and opioid deaths were 6 times higher in 2017 than in 1999. CDC has awarded funding to States to address the nonmedical use of prescription drugs and to address opioid...

Prescription opioids continue to contribute to the opioid overdose epidemic. A prior OIG audit identified high volumes of opioid purchases in IHS communities. In addition, the prior OIG audit of two IHS hospitals determined that IHS did not have adequate information technology (IT) security controls...

Group Health Incorporated, a subsidiary of EmblemHealth, LLC, understated its Cash Balance Plan Medicare segment pension assets as of January 1, 2011, by $366,763.

Group Health Incorporated, a subsidiary of EmblemHealth, LLC, overstated its Local 153 Pension Plan Medicare segment pension assets as of January 1, 2015, by $2.4 million.

Group Health Incorporated, a subsidiary of EmblemHealth, LLC, understated its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare segment pension assets as of January 1, 2015, by $432,584.