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Website
https://oig.hhs.gov/
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
Hotline Page
https://oig.hhs.gov/fraud/report-fraud/index.asp
Whistleblower Protection Page
https://oig.hhs.gov/fraud/whistleblower/?utm_source=oig-home&utm_medium=oig-gfx…

Illinois Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State

2021
A-05-19-00031
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

A previous Office of Inspector General (OIG) audit found that a State Medicaid agency had improperly paid capitation payments on behalf of beneficiaries with concurrent eligibility in another State. We conducted a similar audit of Illinois' Medicaid program.Our objective was to determine whether...

Illinois Claimed Unallowable Telemedicine Payments

2020
A-05-18-00028
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Medicaid telemedicine services are health services delivered via telecommunication systems. A Medicaid patient at an originating site uses audio and video equipment to communicate with a health professional at a distant site. Before the COVID-19 public health emergency, Medicaid programs were seeing...

Hawaii’s Monitoring Generally Ensured Child Care Provider Compliance with State Criminal Background Check Requirements

2020
A-09-19-01000
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Child Care and Development Block Grant Act (CCDBG Act) of 2014 added new requirements for States that receive funding from the Child Care and Development Fund (CCDF) to conduct comprehensive criminal background checks on staff members and prospective staff members of child care providers every 5...

Florida Received Unallowable Medicaid Reimbursement for School-Based Services

2021
A-04-18-07075
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Florida school districts participating in Medicaid as providers certify quarterly that they have used non-Federal education funds for school-based services.Prior Office of Inspector General (OIG) audits identified significant overpayments to school districts for school-based services. In those...

Florida Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Assess, Prioritize, or Investigate Reported Incidents

2021
A-04-17-08058
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

This audit report is one of a series of OIG reports addressing the identification, reporting, and investigation of incidents of potential abuse or neglect of our Nation’s most vulnerable populations, including the elderly and individuals with developmental disabilities. Our objectives were to...

Connecticut Did Not Meet Federal And State Requirements For Claiming Medicaid School-Based Child Health Services For Hartford Public Schools

2020
A-01-19-00003
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

As part of our oversight activities, we are conducting audits of Medicaid school-based services claimed by States. Prior OIG and State audits found that Connecticut did not monitor the School Based Child Health (SBCH) program to ensure that Medicaid-eligible children received services in accordance...

Colorado Improperly Claimed Millions in Enhanced Federal Medicaid Reimbursement For New Adult Group Beneficiaries Because of a Data Processing Error

2021
A-07-17-02807
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

In 2010, Congress passed the Patient Protection and Affordable Care Act (ACA). The ACA established enhanced Federal reimbursement rates for services provided to nondisabled, low-income adults without dependent children (new adult group). The enhanced reimbursement rates established under the ACA...

Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group

2020
A-07-19-02822
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

In 2010, Congress passed the Patient Protection and Affordable Care Act (ACA). The ACA established enhanced Federal reimbursement rates for services provided to nondisabled, low-income adults without dependent children (new adult group). The enhanced reimbursement rates established under the ACA...

Choctaw Nation of Oklahoma Made Progress Toward Meeting Program Goals During the First Year of Its Tribal Opioid Response Grant

2021
A-07-20-04121
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Department of Health and Human Services (HHS), Substance Abuse and Mental Health Services Administration (SAMHSA), has awarded a series of grants to States and Tribes to combat opioid use disorder (OUD). SAMHSA was authorized to award $1 billion in funding for fiscal years (FYs) 2017 and 2018...

California Claimed at Least $2 Million in Unallowable Medicaid Reimbursement for a Selected Provider’s Opioid Treatment Program Services

2021
A-09-20-02001
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The United States currently faces a nationwide public health emergency due to the opioid crisis. Opioid treatment programs (OTPs) provide medication coupled with counseling services (referred to in this report as “OTP services”) for people diagnosed with an opioid use disorder. This audit is part of...

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