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Source Id
395

Illinois Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs

2019
A-05-18-00030
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

For a covered outpatient drug to be eligible for Federal reimbursement under the Medicaid program's drug rebate requirements, manufacturers must pay rebates to the States for the drugs. However, prior OIG reviews found that States did not always invoice and collect all rebates due for drugs...

The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2016 in Accordance With Federal Requirements

2019
A-04-18-04065
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) established the trust fund known as Superfund. The CERCLA requires the Inspector General of a Federal organization with Superfund responsibilities to audit all uses of the fund in the prior fiscal year (FY).

Alaska Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities

2019
A-09-17-02006
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

We have performed reviews in several States in response to a congressional request concerning the number of deaths and cases of abuse of residents with developmental disabilities in group homes.Federal waivers permit States to furnish an array of home and community-based services to Medicaid...

The National Institutes of Health Could Improve Its Monitoring To Ensure That an Awardee of the All of Us Research Program Had Adequate Cybersecurity Controls To Protect Participants' Sensitive Data

2019
A-18-17-09304
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The All of Us Research Program (All of Us) is a major component of the Precision Medicine Initiative. All of Us is responsible for building a national research cohort of more than 1 million participants who will provide their personal health information to the National Institutes of Health (NIH) so...

The Therapy Resource Utilization Groups at Epworth Villa Retirement Community's Skilled Nursing Facility Were Properly Supported

2019
A-06-18-08002
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Skilled Nursing Facility (SNF) claims include Resource Utilization Groups (RUGs) that identify whether a beneficiary received therapy and the range of therapy minutes provided. For example, SNF claims with a RUG that begins with "RU" or "RV" indicate that an ultra high or very high level of therapy...

Princeton Place Did Not Always Comply With Care Plans for Residents Who Were Diagnosed With Urinary Tract Infections

2019
A-06-17-02002
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

A Centers for Medicare & Medicaid Services-sponsored study identified conditions, including urinary tract infections (UTIs), that are associated with potentially avoidable hospitalizations of nursing home residents.

Medicare Could Have Saved Millions of Dollars in Payments for Three-Dimensional Conformal Radiation Therapy Planning Services

2019
A-09-18-03026
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Three-dimensional conformal radiation therapy (3D-CRT) allows doctors to sculpt radiation beams to the shape of a patient's tumor. Medicare makes a single payment to hospitals for development of a 3D-CRT treatment plan. Automated prepayment edits generally prevent additional payments for separately...

Most Hospitals Obtain Compounded Drugs From Outsourcing Facilities, Which Must Meet FDA Quality Standards

2019
OEI-01-17-00090
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

To provide FDA with insights to improve its oversight of compounders and enhance patient safety, OIG determined the extent to which hospitals purchase non-patient-specific compounded drugs from outsourcing facilities.

Medicare Payments to Providers for Polysomnography Services Did Not Always Meet Medicare Billing Requirements

2019
A-04-17-07069
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

From January 1, 2014, through December 31, 2015, Medicare administrative contractors (MACs) nation-wide paid freestanding facilities, facilities affiliated with hospitals, and physicians (collectively referred to as "providers") approximately $800 million for selected polysomnography (a type of...

Incidents of Potential Abuse and Neglect at Skilled Nursing Facilities Were Not Always Reported and Investigated

2019
A-01-16-00509
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

This audit report is one of a series of OIG reports addressing the identification, reporting, and investigation of incidents of potential abuse and neglect of our Nation's most vulnerable populations, including the elderly and individuals with developmental disabilities. Our objectives were to...

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