United States
- Issues about Medicare policy, coverage, billing claims or appeals
- Lost or stolen Medicare card
- Allegations by HHS employees of discrimination on the basis of race, gender, ethnicity, religion or sexual preference
- Allegations by employees or applicants concerning prohibited personnel practices; or Hatch Act violations
- Appeals of administrative decisions made by HHS agencies, grantees or contractors, including Medicare payment decisions and contract or grant awards
- Appeals of judicial decisions by federal or state courts involving HHS programs
- Complaints of failure to safeguard medical information, i.e. HIPAA violations
- Customer service complaints involving HHS employees, grantees or contractors
- Allegations of identity theft unrelated to HHS programs
- Disability fraud
- SNAP/Food Stamp Fraud
- Self-Disclosures
North Mississippi Medical Center: Audit of Medicare Payments for Polysomnography Services
Noridian Healthcare Solutions, LLC, Made Improper Medicare Payments of $4 Million to Physicians in Jurisdiction E for Spinal Facet-Joint Injections
Facet-joint injections of an anesthetic with or without a steroid are used to diagnose or treat chronic neck and back pain. A prior Office of Inspector General (OIG) review found that 47 percent of Medicare payments to physicians for facet-joint injections nationwide in calendar year (CY) 2006, or...
Noridian Healthcare Solutions, LLC, Claimed Unallowable Medicare Nonqualified Restoration Savings Plan Costs Through Its Incurred Cost Proposals
NHS is a subsidiary of Blue Cross Blue Shield of North Dakota (BCBS North Dakota) (formerly Noridian Mutual Insurance Company), whose home office is in Fargo, North Dakota. NHS administered Medicare Part A, Medicare Part B, and Medicare Durable Medical Equipment (DME) contract operations under MAC...
Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals
Noridian Healthcare Solutions, LLC, and MedicareNHS is a subsidiary of Blue Cross Blue Shield of North Dakota (BCBS North Dakota) (formerly Noridian Mutual Insurance Company), whose home office is in Fargo, North Dakota. NHS administered Medicare Part A, Medicare Part B, and Medicare Durable Medical...
New York Made Unallowable Payments Totaling More Than $9 Million to the Same Managed Care Organization for Beneficiaries Assigned More Than One Medicaid Identification Number
New York Did Not Have Adequate Oversight of Its Reported Temporary Assistance for Needy Families Program Expenditures
BACKGROUNDThe Temporary Assistance for Needy Families ProgramThe Personal Responsibility and Work Opportunity Reconciliation Act of 1996 established the TANF program to help families progress from welfare to self-sufficiency. Under TANF, the Federal government provides States $16.6 billion in annual...
National Background Check Program for Long-Term-Care Providers: Assessment of State Programs Concluded in 2019
Minnesota Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State
Previous Office of Inspector General (OIG) audits found that State Medicaid agencies had improperly paid capitation payments on behalf of beneficiaries with concurrent eligibility in another State. We conducted a similar audit of Minnesota’s Medicaid program.Our audit covered 7,706 August 2018...
Medicare Made Millions of Dollars in Overpayments for End-Stage Renal Disease Monthly Capitation Payments
Physicians managing center-based ESRD patients can be paid an MCP that covers most outpatient dialysis-related physician services provided to each Medicare beneficiary who is being treated for ESRD. , The MCP varies based on the beneficiary’s age and the number of visits during each calendar month...