Department of Health & Human Services OIG

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. However, a prior OIG audit found that States did not always invoice and collect all rebates due for drugs...

A prior OIG audit found that New York made more than $7 million in unallowable Federal Medicaid payments to different managed care organizations (MCOs) for the same month for beneficiaries assigned more than one Medicaid identification (ID) number. A recent analysis of Medicaid data showed that New...

Drug diversion, counterfeiting, and the importation of unapproved drugs may result in potentially dangerous drugs entering the drug supply chain, posing a threat to public health and safety. To enhance the security of this supply chain, the Drug Supply Chain Security Act (DSCSA) requires trading...

For fiscal year 2019, the Department of Health and Human Services (HHS), Office of Inspector General (OIG) received $5 million in congressional appropriations to conduct oversight of the National Institutes of Health (NIH) grant programs and operations. Among the issues of interest to Congress were...

Medicare makes supplemental payments to hospitals, known as outlier payments, which are designed to protect hospitals from significant financial losses resulting from patient-care cases that are extraordinarily costly. Unlike predetermined payment amounts for most Medicare hospital claims, outlier...

A 2008 HHS review of its acquisition process concluded that HHS components, including the Centers for Medicare & Medicaid Services (CMS), did not always obligate and expend funds in compliance with Federal requirements. As a result, in July 2011, HHS reported a department-wide Antideficiency Act...

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

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of their grants. As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports...

Historically, only certain groups of individuals who had incomes and assets below certain thresholds were eligible for Medicaid (traditional coverage groups). After the passage of the Patient Protection and Affordable Care Act (ACA), some beneficiaries remained eligible under these traditional...

The Grants Oversight and New Efficiency (GONE) Act, P.L. 114-117, enacted on January 28, 2016, established mandatory reporting requirements for Federal Departments and Inspectors General Offices related to grant awards and cooperative agreements expired for 2 or more years that have not been closed...