Department of Health & Human Services OIG

Previous Office of Inspector General (OIG) audits found that States had improperly paid Medicaid managed care entities capitation payments on behalf of deceased beneficiaries. We conducted a similar audit of the North Carolina Department of Health and Human Services, Division of Health Benefits...

The Stewart B. McKinney Homeless Assistance Amendments Act of 1990 (Stewart B. McKinney Act) established the PATH program, which is administered at the Federal level by SAMHSA. SAMHSA awards PATH grants to States using a formula. States use the grants to fund local public and nonprofit organizations...

Prior OIG audits found that New York did not effectively monitor its Medicaid personal care services program and, as a result, made more than $375 million in Federal Medicaid payments for services that did not comply with Federal and State requirements. This audit was conducted to determine whether...

We have performed audits in several States, including New York, in response to a congressional request concerning deaths and 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 Medicaid program provides medical assistance to low-income individuals and individuals with disabilities. The Federal and State Governments jointly fund and administer the Medicaid program. At the Federal level, the Centers for Medicare & Medicaid Services (CMS) administers the program. Each...

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. Previous OIG audits found that States did not always bill and collect all rebates due for drugs administered by...

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. States bill the manufacturers for rebates to reduce the cost of drugs to the program. However, previous Office of Inspector...

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 and who have elected hospice care. Previous OIG reviews found that Medicare inappropriately paid for hospice services that did not...

The Medicare hospice benefit allows providers to claim Medicare reimbursement for hospice servicesprovided to individuals with a life expectancy of 6 months or less and who have elected hospice care.Previous OIG reviews found that Medicare inappropriately paid for hospice services that did not...

BACKGROUNDThe Medicare ProgramTitle XVIII of the Social Security Act (the Act) established the Medicare program, which provideshealth insurance coverage to people aged 65 and over, people with disabilities, and people withend-stage renal disease. The Centers for Medicare & Medicaid Services (CMS)...