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Source Id
395

Some Diagnosis Codes That Essence Healthcare, Inc., Submitted to CMS Did Not Comply With Federal Requirements

2019
A-07-17-01170
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Under the Medicare Advantage (MA) program, the Centers for Medicare & Medicaid Services (CMS) makes predetermined monthly payments to MA organizations according to a system of risk adjustment that depends on the health status of each enrollee. Accordingly, MA organizations are paid more for...

Trends in Deficiencies at Nursing Homes Show That Improvements Are Needed To Ensure the Health and Safety of Residents

2019
A-09-18-02010
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

In this data brief, we analyze nursing home deficiencies that were identified by State survey agencies (State agencies) across the Nation for calendar years 2013 through 2017 (review period). This data brief offers the Centers for Medicare & Medicaid Services (CMS) and other stakeholders (e.g...

The Children's Village, Inc., an Administration for Children and Families Grantee, Did Not Always Comply with Applicable Federal and State Policies and Requirements

2019
A-02-16-02013
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Office of Refugee Resettlement (ORR) within the Department of Health and Human Services (HHS), Administration for Children and Families, manages the Unaccompanied Alien Children (UAC) program. The UAC program served between 7,000 and 8,000 children annually from fiscal years (FYs) 2005 through...

The Centers for Disease Control and Prevention's South Africa Office Generally Implemented Our Prior Audit Recommendation

2019
A-04-18-01009
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The President's Emergency Plan for AIDS Relief (PEPFAR) was authorized 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. Additional funds were authorized to be appropriated through 2023.

A Queens Chiropractor Received Improper Medicare Payments for Chiropractic Services

2019
A-02-15-01003
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Nearly all Medicare Part B payments to a chiropractor in Queens, New York, did not comply with Medicare requirements. Specifically, 95 of 100 sample claims for which the chiropractor received Medicare Part B reimbursement did not comply with Medicare requirements. These improper payments occurred...

National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded Between 2013 and 2016

2019
OEI-07-16-00160
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

Background checks are an important safety measure that can help protect the 9 million beneficiaries who rely on long-term-care services each year for safe, dependable care. These checks can prevent individuals with disqualifying histories (e.g., convictions for patient abuse, patient neglect, and...

Review of the Department of Health and Human Services’ Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2018

2019
A-18-18-11200
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Overall, the Department continues to implement changes to strengthen its enterprise-wide information security program. We identified opportunities where the Department can strengthen their overall information security program. The Department continues to work toward implementing a Department-wide...

Washington State Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program

2019
A-09-18-01001
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

We identified actions that Washington has taken, using Federal funds for improving prescription drug monitoring programs (PDMPs), to achieve program goals toward improving safe prescribing practices and preventing prescription drug abuse and misuse. As of July 2018, Washington had completed some of...

Concerns About Opioid Use in Medicare Part D in the Appalachian Region

2019
OEI-02-18-00224
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

Overdose deaths are at epidemic levels and the opioid crisis is now considered a public health emergency. In 2016, there were more than 42,000 opioid-related overdose deaths in the United States-115 deaths per day. Nearly 7,000 of these deaths occurred in five States in the Appalachian region...

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