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
Illinois Medicaid Fraud Control Unit: 2019 Onsite Inspection
Hospitals Did Not Comply With Medicare Requirements for Reporting Cardiac Device Credits
Manufacturer Credits and Payment Reductions for Medical DevicesFederal regulations and guidance specify how hospitals must report the replacement of a beneficiary’s implanted device if a hospital receives a full or partial credit from the manufacturer for a medical device that is covered under...
Hospital Experiences Responding to the COVID-19 Pandemic: Hospital Pulse Surveys II
HHS Made Some Progress Toward Compliance with the Geospatial Data Act
On October 5, 2018, the President signed into law the GDA as part of the FAA Reauthorization Act of 2018 (P.L. No. 115-254, Subtitle F). The purpose of the GDA is to foster efficient administration of geospatial data, technologies, and infrastructure by improving the coordination and partnerships...
Group Health Incorporated Overstated its Local 153 Pension Plan Medicare Segment Assets and Understated Medicare's Share of Medicare Segment Pension Assets as of August 31, 2016
GHI, a subsidiary of EmblemHealth Services Company, LLC, administered Medicare operations under a Coordination of Benefits contract with CMS. During our audit period, GHI also performed Medicare work on the Medicare Secondary Payer Recovery and Benefit Coordination and Recovery contracts. GHI also...
Group Health Incorporated Overstated its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of December 31, 2015
GHI, a subsidiary of EmblemHealth Services Company, LLC, administered Medicare operations under a Coordination of Benefits contract with CMS. During our audit period, GHI also performed Medicare work on the Medicare Secondary Payer Recovery and Benefit Coordination and Recovery contracts. GHI also...
Group Health Incorporated Overstated Its Allowable Medicare Supplemental Executive Retirement Plan Costs for Calendar Years 2009 Through 2016
GHI, a subsidiary of EmblemHealth Services Company, LLC, administered Medicare operations under Coordination of Benefits (COB) contracts with CMS. During our audit period, GHI also performed Medicare work on the Medicare Secondary Payer Recovery and Benefit Coordination and Recovery (MSPRC)...
Group Health Incorporated Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2009 Through 2016
GHI, a subsidiary of EmblemHealth Services Company, LLC, administered Medicare operations under a Coordination of Benefits (COB) contract with CMS. During our audit period, GHI also performed Medicare work on the Medicare Secondary Payer Recovery and Benefit Coordination and Recovery (MSPRC)...
Group Health Incorporated Claimed Some Unallowable Medicare Postretirement Benefit Costs for Calendar Years 2009 Through 2016
GHI, a subsidiary of EmblemHealth Services Company, LLC, administered Medicare operations under Coordination of Benefits (COB) contracts with CMS. During our audit period, GHI also performed Medicare work on the Medicare Secondary Payer Recovery and Benefit Coordination and Recovery (MSPRC)...