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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

Factsheet: Alabama's Oversight of Opioid Prescribing and Monitoring of Opioid Use

2020
A-04-19-00125
Other
Department of Health & Human Services OIG
Department of Health & Human Services

We reviewed the oversight of opioid prescribing and the monitoring of opioid use in Alabama. This factsheet shows Alabama's responses to our questionnaire covering five categories related to its approach to addressing the opioid epidemic: policies and procedures, data analytics, programs, outreach...

Pathways for Children Needs To Strengthen Documentation Requirements

2020
A-01-18-02503
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Improving Head Start for School Readiness Act of 2007 required the U.S. Department of Health and Human Services, Administration for Children and Families (ACF), Office of Head Start (OHS), to develop the Designation Renewal System to ensure that it would not automatically renew a Head Start...

Medicare Hospital Provider Compliance Audit: Northwest Medical Center

2020
A-04-18-08064
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

This review is part of a series of hospital compliance reviews. 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...

Medicare Hospital Provider Compliance Audit: Northwest Medical Center

2020
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

This review is part of a series of hospital compliance reviews. 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...

Medicare Hospital Provider Compliance Audit: Carolinas Hospital

2020
A-04-18-08063
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...

Fall 2019 Semiannual Report to Congress

2019
Semiannual Report
Department of Health & Human Services OIG
Department of Health & Human Services

This fall edition of the Semiannual Report to Congress covers OIG activities from April 2019 through September 2019. Historically, about 80 percent of OIG's resources are directed to work related to Medicare and Medicaid. This is mirrored in the content of the report.

Hospitals Received Millions in Excessive Outlier Payments Because CMS Limits the Reconciliation Process

2020
A-05-16-00060
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Outlier claim payments are based on hospital cost reports from the latest cost-reporting period for which the cost report is either settled as final or tentatively settled. The Centers for Medicare & Medicaid Services (CMS) requires its Medicare administrative contractors to reconcile outlier...

Noridian Healthcare Solutions, LLC, Did Not Claim Allowable Medicare Nonqualified Costs Through Its Incurred Cost Proposals

2020
A-07-19-00573
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Centers for Medicare & Medicaid Services (CMS) reimburses a portion of its contractors' nonqualified plan (nonqualified) costs.At CMS's request, the U.S. Department of Health and Human Services, Office of Inspector General (OIG), Office of Audit Services, Region VII pension audit team reviews...

Noridian Healthcare Solutions, LLC, Did Not Claim Allowable Medicare Nonqualified Costs

2020
A-07-19-00574
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

At CMS's request, the U.S. Department of Health and Human Services, Office of Inspector General (OIG), Office of Audit Services, Region VII pension audit team reviews the cost elements related to nonqualified plans and any other pension-related cost elements claimed by Medicare contractors through...

Cahaba Safeguard Administrators, LLC, Properly Updated the Medicare Segment Pension Assets as of January 1, 2017

2020
A-07-19-00571
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Medicare contractors are required to separately account for the Medicare segment pension plan assets based on the requirements of Cost Accounting Standards 412 and 413. The U.S. Department of Health and Human Services, Office of Inspector General (OIG), Office of Audit Services, Region VII pension...

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