Department of Health & Human Services OIG

Medicare Part B covers dialysis services for beneficiaries with end-stage renal disease (ESRD). Prior OIG reviews identified inappropriate Medicare payments made for ESRD (dialysis) services that were medically unnecessary, not properly ordered, undocumented, or did not comply with Medicare...

We are performing reviews in several States in response to a congressional request concerning deaths and abuse of people with developmental disabilities living in group homes.Federal waivers permit States to furnish an array of home and community-based services to Medicaid members with developmental...

In New York, adult day care facilities provide functionally impaired adults with socialization, supervision and monitoring, and nutrition services in a protective setting. Beneficiaries enrolled in New York's Medicaid managed long-term-care program receive adult day care services from providers...

This audit is part of a larger body of Congressionally directed work to conduct oversight of National Institutes of Health (NIH) grant programs and operations. OIG was directed to examine NIH's oversight of its grantees' compliance with NIH policies, including NIH efforts to ensure the integrity of...

In 2016, the Centers for Medicare & Medicaid Services (CMS) updated its life safety and emergency preparedness regulations to improve protections for all Medicare and Medicaid beneficiaries, including those residing in long-term-care facilities (commonly referred to as nursing homes). Updates...

To address the increased need for treatment services, the 21st Century Cures Act established the State Targeted Response to the Opioid Crisis grant program (STR grant program). Through this program, SAMHSA awarded almost $1 billion in grants to States over a 2-year grant period (May 2017 through...

Provider-preventable conditions (PPCs) are certain reasonably preventable conditions caused by medical accidents or errors in a healthcare setting. In 2011, the Centers for Medicare & Medicaid Services (CMS) issued Federal regulations prohibiting Federal Medicaid payments for services related to...

In spring 2018, the Department of Justice and Department of Homeland Security (DHS) adopted a zero-tolerance policy under which large numbers of families entering the United States without authorization were separated by DHS.

When Congress established average sales price (ASP) as the basis for Medicare Part B drug reimbursement, it also provided a mechanism for monitoring market prices and limiting potentially excessive payment amounts.

In 2016, the Centers for Medicare & Medicaid Services (CMS) updated its life safety and emergency preparedness regulations to improve protections for all Medicare and Medicaid beneficiaries, including residents of long-term-care facilities (commonly referred to as nursing homes). Updates included...