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Abbreviation
HHSOIG
Agencies
Department of Health & Human Services
Federal Agency
Yes
Location

United States

What to Report to the OIG Hotline
The U.S. Department of Health and Human Services (HHS) Office of Inspector General's (OIG) mission is to protect the integrity of HHS programs as well as the health and welfare of program beneficiaries. In doing so, we rely on complaints by HHS employees, contractors, subcontractors, grantees and subgrantees (i.e. whistleblowers) who report fraud, waste, abuse or mismanagement in HHS programs. We also review and investigate reports of whistleblower retaliation. If you would like more information on what kinds of complaints our OIG investigates, please visit our website at https://oig.hhs.gov/fraud/report-fraud/before-you-submit.asp. There you will find a list of things you should know before submitting a complaint to the OIG. If you would like more information on the types of whistleblowers protected by the OIG, please visit our whistleblower protection page at https://oig.hhs.gov/fraud/report-fraud/whistleblower.asp. If you are a whistleblower and wish to report fraud, waste, abuse or mismanagement in HHS programs, or you wish to report whistleblower retaliation, please visit our Hotline at https://oig.hhs.gov/fraud/report-fraud/index.asp.
What Not to Report to the OIG Hotline
  • 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

Medicare Hospice Provider Compliance Audit: Franciscan Hospice

2021
A-09-20-03034
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Our audit covered 21,537 claims for which Franciscan (located in University Place, Washington) received Medicare reimbursement of $101.5 million for hospice services provided from January 1, 2016, through December 31, 2017. We reviewed a random sample of 100 claims. We evaluated compliance with...

Medicare Hospice Provider Compliance Audit: Ambercare Hospice, Inc.

2021
A-09-18-03017
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Medicare hospice benefit allows providers to claim Medicare reimbursement for hospice services provided to individuals with a life expectancy of 6 months or less who have elected hospice care. Previous OIG audits and evaluations found that Medicare inappropriately paid for hospice services that...

Medicare Hospice Provider Compliance Audit: Alive Hospice, Inc.

2021
A-09-18-03016
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Medicare hospice benefit allows providers to claim Medicare reimbursement for hospice services provided to individuals with a life expectancy of 6 months or less who have elected hospice care. Previous OIG audits and evaluations found that Medicare inappropriately paid for hospice services that...

Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Maryland

2021
A-03-17-00009
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Under the home health prospective payment system (PPS) during calendar years 2015 and 2016, the Centers for Medicare & Medicaid Services paid home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary received. The PPS payment covers part-time or...

Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Central Jersey Home Care and Hospice, Inc.

2021
A-02-17-01025
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Under the home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide visits...

Medicare Home Health Agency Provider Compliance Audit: Total Patient Care Home Health, LLC

2021
A-06-16-05005
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Under the home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide visits...

Medicare Home Health Agency Provider Compliance Audit: The Palace at Home

2021
A-04-17-07067
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Under the Medicare home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide...

Medicare Home Health Agency Provider Compliance Audit: Tender Touch Health Care Services

2021
A-04-18-07077
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Under the home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide visits...

Medicare Home Health Agency Provider Compliance Audit: Southeastern Home Health Services

2021
A-03-17-00004
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Under the home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers part-time or intermittent skilled nursing care and home...

Medicare Home Health Agency Provider Compliance Audit: Mercy Health Visiting Nurse Services

2020
A-05-18-00035
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Medicare Parts A and B cover eligible home health services under a prospective payment system (PPS). The PPS covers part-time or intermittent skilled nursing care and home health aide visits, therapy (physical, occupational, and speech-language pathology), medical social services, and medical...

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