Department of Health & Human Services OIG

New Jersey pays managed care organizations (MCOs) to make managed long-term services and supports (MLTSS) available to Medicaid beneficiaries in home and community-based settings. Recent OIG audits of Medicaid home and community-based and managed long-term-care services identified significant...

The Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019, and Continuing Appropriations Act, 2019, P.L. No. 115-245, directed OIG to examine the efforts of the National Institutes of Health (NIH) to ensure the integrity of its grant application...

The Department of Defense and Labor, Health and Human Services, and Education Appropriations Act, 2019 and Continuing Appropriations Act 2019, P.L. No. 115-245, directed OIG to examine the efforts of the National Institutes of Health (NIH) to ensure the integrity of its grant application evaluation...

As the Nation continues to struggle with the opioid crisis, it is vital to gain a deeper understanding of those who are at risk of misuse or overdose. The 2020 COVID-19 pandemic makes the need to look at this population even more pressing. The National Institutes of Health recently issued a warning...

The Office of Inspector General (OIG) must review the Department of Health and Human Services (HHS) compliance with the Improper Payments Information Act of 2002 (IPIA; P.L. No. 107-300) as amended by the Improper Payments Elimination and Recovery Act of 2010 (P.L. No. 111-204) and the Improper...

The Medicaid "health home" option allows States to create programs that provide care coordination and care management for beneficiaries with chronic health conditions. Health homes are not physical spaces. Rather, they are a healthcare model in which providers work together to coordinate and manage...

Health care coalitions (HCCs) help prepare their community health care systems to respond to public health emergencies, such as natural disasters. HCCs are member-led and are composed of health care entities and other response entities that voluntarily work together to coordinate an emergency...

Prior OIG audits identified significant overpayments to hospital outpatient providers for nonphysician services furnished shortly before or during inpatient stays. In those audits, we recommended that the Centers for Medicare & Medicaid Services (CMS) recover overpayments, ensure that edits to...

Illinois' monitoring of childcare providers did not ensure provider compliance with State requirements related to criminal background checks at 12 of 30 childcare provider locations we reviewed. We found that 2 of 327 individuals did not obtain 1 or more of the required criminal background checks...

Medicare contractors are required to separately account for the Medicare segment pension plan assets based on the requirements of Cost Accounting Standards (CAS) 412 and 413.The HHS, OIG, Office of Audit Services, Region VII pension audit team reviews the Medicare segment pension assets to ensure...