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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

Freedom Orthotics, Inc.: Audit of Medicare Payments for Orthotic Braces

2020
A-09-19-03012
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

From July 1, 2016, through December 31, 2018 (audit period), Medicare paid approximately $4 billion for orthotic braces provided to Medicare beneficiaries. Prior OIG audits found that some suppliers of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) billed for orthotic...

Hawaii Medicaid Fraud Control Unit: 2019 Onsite Review

2020
OEI-06-19-00110
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

The purpose of this review was to identify and address factors that contributed to the Hawaii Medicaid Fraud Control Unit's (MFCU's or Unit's) low case outcomes during federal fiscal years (FYs) 2016-18 and to assess Unit operations. In 2015, OIG issued a report from its 2014 onsite review of the...

Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2020

2020
OEI-05-20-00190
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

This report fulfills for 2020 the annual reporting mandate from the Patient Protection and Affordable Care Act (ACA). The ACA requires OIG to conduct a study of the extent to which formularies used by Medicare Part D plans include drugs commonly used by full benefit dual eligible individuals (i.e...

2019 Performance Data for the Senior Medicare Patrol Projects

2020
OEI-02-20-00150
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

This memorandum report presents performance data for the Senior Medicare Patrol (SMP) projects, which receive grants from ACL to recruit and train retired professionals and other older adults and community members to recognize and report instances or patterns of health care fraud. OIG has collected...

The Office of Refugee Resettlement's Incident Reporting System Is Not Effectively Capturing Data To Assist Its Efforts To Ensure the Safety of Minors in HHS Custody

2020
OEI-09-18-00430
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

The Department of Health and Human Services (HHS), Administration for Children and Families (ACF), Office of Refugee Resettlement (ORR), has custody of and must provide care to minors (children younger than 18 years of age) in the Unaccompanied Alien Children (UAC) Program. ORR is responsible for...

Unaccompanied Alien Children Program Care Provider Facilities Do Not Include All Required Security Measures in Their Checklists

2020
OEI-05-19-00210
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

Protecting children in the Unaccompanied Alien Children (UAC) Program is an essential and ongoing responsibility of the Office of Refugee Resettlement (ORR). By law, ORR, which is within the Department of Health and Human Services' ACF, has custody of and must provide care for each child in the UAC...

Texas Telemedicine Services Were Provided in Accordance with State Requirements

2020
A-06-18-05001
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 located at a patient site uses audio and video equipment to communicate with a physician or licensed practitioner located at a distant site. Medicaid views telemedicine services as a cost...

Medicare Hospital Provider Compliance Audit: The Ohio State University Hospital

2020
A-05-18-00042
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

This audit is part of a series of hospital compliance audits. Using computer matching, data mining, and data analysis techniques, we identified hospital claims that were at risk for noncompliance with Medicare billing requirements. For calendar year 2017, Medicare paid hospitals $206 billion, which...

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