Department of Health & Human Services OIG

Previous OIG reviews found that States had improperly paid Medicaid Managed Care Organizations (MCOs) capitation payments on behalf of deceased beneficiaries. We conducted a similar review of the Illinois Department of Healthcare and Family Services, which administers the Medicaid program. Our...

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...

IHS provides comprehensive Federal health services to approximately 2.6 million American Indians and Alaska Natives. OIG and others have found significant problems in the quality of care and oversight of IHS hospitals. This study identifies underlying organizational challenges that may hamper IHS's...

OIG administers Medicaid Fraud Control Unit (MFCU) grant awards, annually recertifies each MFCU, and oversees MFCU performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of MFCUs and prepares public reports. These onsite reviews...

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

The objective of this report is to summarize key findings identified in 2013 reports and in 2016 followup reports produced by 13 Federal agency Offices of Inspectors General (OIGs) regarding original and derivative classification and Classified National Security Information (CNSI) program management...

In 2012, we issued a report to the Centers for Medicare & Medicaid Services (CMS) indicating that during 2009, Medicare Part D paid for prescription drugs that likely should have been paid for by hospice organizations under the Medicare Part A hospice benefit. We matched Part A and Part D data to...

Background checks are an important safety measure that can help protect the 9 million beneficiaries who rely on long-term-care services each year for safe, dependable care. These checks can prevent individuals with disqualifying histories (e.g., convictions for patient abuse, patient neglect, and...

The Social Security Act requires that each Medicare administrative contractor (MAC) have its information security program evaluated annually by an independent entity. The Centers for Medicare & Medicaid Services (CMS) contracted with Guidehouse, LLP (Guidehouse), to evaluate information security...

The Administration for Children and Families' (ACF's) oversight of the Low-Income Home Energy Assistance Program (LIHEAP) did not ensure that grant funds were (1) used to provide the maximum available LIHEAP benefits to eligible households and (2) consistently administered in accordance with Federal...