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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

Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Pension Assets

2020
A-07-18-00547
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 their Medicare contracts and Cost Accounting Standards (CAS) 412 and 413.The U.S. Department of Health and Human Services, Office of Inspector General (OIG), Office of...

Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Pension CostsTitle

2020
A-07-18-00548
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Centers for Medicare & Medicaid Services (CMS) reimburses contractors for a portion of their pension costs, which are funded by the annual contributions that contractors make to their pension plans.At CMS's request, the U.S. Department of Health and Human Services, Office of Inspector General...

Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Postretirement Benefit Assets

2020
A-07-19-00567
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Centers for Medicare & Medicaid Services (CMS) reimburses a portion of Medicare contractors' costs for postretirement benefit (PRB) plans. 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...

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

2020
A-07-19-00568
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Centers for Medicare & Medicaid Services (CMS) reimburses contractors for a portion of their postretirement benefit (PRB) costs, which are funded by the contributions that contractors make to their dedicated trust fund.At CMS's request, the U.S. Department of Health and Human Services, Office of...

Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs

2020
A-07-19-00569
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Centers for Medicare & Medicaid Services (CMS) reimburses contractors for a portion of their postretirement benefit (PRB) costs, which are funded by the contributions that contractors make to their dedicated trust fund.At CMS's request, the U.S. Department of Health and Human Services, Office of...

Medicare Improperly Paid Acute-Care Hospitals $54.4 Million for Inpatient Claims Subject to the Post-Acute-Care Transfer Policy

2020
A-09-19-03007
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Prior OIG reviews identified almost $242 million in overpayments to hospitals that did not comply with Medicare's post-acute-care transfer policy (transfer policy). These hospitals transferred patients to certain post-acute-care settings, such as skilled nursing facilities (SNFs), but claimed the...

Medicare Allowable Amounts for Certain Orthotic Devices Are Not Comparable With Payments Made by Select Non-Medicare Payers

2020
A-05-17-00033
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

For calendar years (CYs) 2012 through 2015, Medicare allowable amounts for certain back, knee, elbow, and wrist orthotic devices increased from $631.8 million to $815.5 million. We are concerned about the relationship of these increased costs to prices per orthotic device, and specifically whether...

Medicare Improperly Paid Suppliers an Estimated $92.5 Million for Inhalation Drugs

2020
A-09-18-03018
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Since 2010, the Centers for Medicare & Medicaid Services' (CMS's) Comprehensive Error Rate Testing (CERT) program has identified nebulizers and related drugs (i.e., inhalation drugs) among the top 20 supplies with the highest improper Medicare payments. Prior OIG reviews (for calendar years (CYs)...

Medicare Home Health Agency Provider Compliance Review: Angels Care Home Health

2020
A-07-16-05093
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Under the Medicare home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide...

Tennessee Made Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid Identification Numbers

2020
A-04-18-07079
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Previous Office of Inspector General reviews identified Federal Medicaid reimbursement for managed care payments that were not claimed in compliance with Federal requirements. Specifically, some beneficiaries enrolled in Medicaid managed care had more than one Medicaid identification (ID) number. As...

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