Department of Health & Human Services OIG

The 2017 U.S. Department of Health and Human Services (HHS) Budget in Brief states that excluding authorized generics from average manufacturer price (AMP) calculations could save the Federal Government $20 million per year. A prior Office of Inspector General (OIG) report indicated that this is a...

Previous OIG work found that Medicaid may have paid for drugs in 2008 that were not approved by the Food and Drug Administration (FDA) as safe and effective. To qualify for Federal payments under Medicaid, drugs must be FDA-approved unless they meet the criteria for an exception-for example...

Under the Medicare Advantage (MA) program, the Centers for Medicare & Medicaid Services (CMS) makes predetermined monthly payments to MA organizations according to a system of risk adjustment that depends on the health status of each enrollee. Accordingly, MA organizations are paid more for...

In this data brief, we analyze nursing home deficiencies that were identified by State survey agencies (State agencies) across the Nation for calendar years 2013 through 2017 (review period). This data brief offers the Centers for Medicare & Medicaid Services (CMS) and other stakeholders (e.g...

The Office of Refugee Resettlement (ORR) within the Department of Health and Human Services (HHS), Administration for Children and Families, manages the Unaccompanied Alien Children (UAC) program. The UAC program served between 7,000 and 8,000 children annually from fiscal years (FYs) 2005 through...

The President's Emergency Plan for AIDS Relief (PEPFAR) was authorized to receive $48 billion in funding for the 5-year period beginning October 1, 2008, to assist foreign countries in combating HIV/AIDS, tuberculosis, and malaria. Additional funds were authorized to be appropriated through 2023.

Nearly all Medicare Part B payments to a chiropractor in Queens, New York, did not comply with Medicare requirements. Specifically, 95 of 100 sample claims for which the chiropractor received Medicare Part B reimbursement did not comply with Medicare requirements. These improper payments occurred...

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...

Overall, the Department continues to implement changes to strengthen its enterprise-wide information security program. We identified opportunities where the Department can strengthen their overall information security program. The Department continues to work toward implementing a Department-wide...

We identified actions that Washington has taken, using Federal funds for improving prescription drug monitoring programs (PDMPs), to achieve program goals toward improving safe prescribing practices and preventing prescription drug abuse and misuse. As of July 2018, Washington had completed some of...