Department of Health & Human Services OIG

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...

The Patient Protection and Affordable Care Act gave States the option to expand Medicaid coverage to low-income adults without dependent children and established enhanced Federal reimbursement rates (Federal Medical Assistance Percentage, or FMAP) for services provided to beneficiaries enrolled...

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based...

The U.S. Department of Health and Human Services (HHS), Food and Drug Administration (FDA), did not submit an Office of Inspector General (OIG) clearance document for any of the 166 audit recommendations, which were identified in OIG stewardship reports, during Federal fiscal years (FYs) 2015 and...

Historically, national Medicaid data—a collection of data submitted by all States—have not been complete, accurate, and timely. These data have not yet been adequate for national analysis and oversight, even though some States' data have been sufficient for individual State analysis. Because of...

As part of HHS's Administration for Children and Families (ACF), the Office of Refugee Resettlement (ORR) manages the Unaccompanied Alien Children (UAC) program. ORR awards funds, primarily through grants, to organizations to provide residential care to UAC.Our objective was to assess whether...

The Unaccompanied Alien Children (UAC) program, which is overseen by HHS's Office of Refugee Resettlement (ORR), served between 7,000 and 8,000 children annually from fiscal year (FYs) 2005 through 2011. In FY 2012, the number of children served in the program increased to 13,625. In FY 2014, ORR...

Connecticut did not always comply with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs. Connecticut did not invoice manufacturers for rebates associated with $1.1 million (Federal share) in physician-administered drugs. Of this amount, $1.07...

HHS, Health Resources and Services Administration (HRSA), is subject to Federal audits of its internal activities as well as Federal and non-Federal audits of activities performed by its grantees and contractors. As a followup to these audits, HRSA is responsible for resolving Federal and non...

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. The Social Security Act mandates that OIG compare ASPs with average manufacturer...