Department of Health & Human Services OIG

Federal regulations effective July 1, 2011, prohibit Medicaid payments for services related to treating provider-preventable conditions (PPCs). The Centers for Medicare & Medicaid Services delayed its enforcement of the regulations until July 1, 2012, to allow States time to develop and implement...

The Centers for Medicare & Medicaid Services (CMS) uses area wage indexes to adjust Medicare payments to reflect local labor prices. CMS calculates new wage indexes annually from wage data (wages, wage-related costs, and hours) submitted by hospitals. We selected Rhode Island Hospital (the Hospital)...

The Affordable Care Act established the Medicare Shared Savings Program (MSSP). Accountable Care Organizations (ACOs) in the MSSP may be eligible to receive shared savings payments from the Centers for Medicare & Medicaid Services (CMS) if they reduce healthcare costs and satisfy the quality...

The Child Care and Development Fund (CCDF) program, administered by the Administration for Children and Families, subsidizes childcare expenditures of low-income families and families receiving temporary public assistance.

NDF did not always claim and account for HHS grant funds in accordance with Federal requirements. We identified unallowable claims for indirect costs totaling $142,104. We also identified other costs totaling $15,618 that did not fully meet Federal requirements but were related to the purpose of the...

We estimated that Minnesota made unallowable capitation payments totaling at least $3.7 million ($3.2 million Federal share) to MCOs on behalf of deceased beneficiaries during our audit period. Of the 100 capitation payments in our random sample, Minnesota made 95 unallowable payments totaling $62...

National Government Services, Inc., claimed unallowable Medicare Supplemental Executive Retirement Plan costs of $268,633 on its Incurred Cost Proposals for calendar years 2007 through 2014.

We revised some of our calculations of the Medicare segment pension costs for this final report. We incorporated the ICP audit adjustments because the ICP audit report from the independent accounting firms has been issued in final. The ICP auditors incorporated our pension adjustments from our prior...

National Government Services, Inc., claimed unallowable Medicare nonqualified costs of $971,820 through its Incurred Cost Proposals for calendar years 2007 through 2014.