Department of Health & Human Services OIG

Prior OIG reviews identified significant Medicare Part B overpayments, including those to ambulance suppliers, for services they provided to Medicare beneficiaries during skilled nursing facility (SNF) stays covered under Medicare Part A. The Centers for Medicare & Medicaid Services (CMS) generally...

State survey agencies (State agencies) must verify that nursing homes corrected identified deficiencies, such as the failure to provide necessary care and services, before certifying whether the nursing homes are in substantial compliance with Federal participation requirements for Medicare and...

Although the U.S. Department of Health and Human Services (HHS), Centers for Medicare & Medicaid Services (CMS), has made significant progress in the timely resolution of audit recommendations since our previous review (of Federal fiscal years (FYs) 2006 and 2007), CMS did not always resolve audit...

In the Spring of 2018, the Department of Justice and Department of Homeland Security (DHS) implemented a "zero-tolerance policy" for certain immigration offenses. As a result, DHS separated large numbers of alien families, with adults being held in Federal detention while their children were...

From January 1, 2015, through March 31, 2017 (audit period), Kelley Medical Equipment and Supply, LLC (Kelley Medical), which is located in Durant, Oklahoma, did not always comply with Medicare requirements when billing for selected orthotic braces (i.e., back, knee, and ankle-foot braces). For 24...

While New York implemented some background check requirements established under the Child Care and Development Block Grant (CCDBG) Act, it had not fully implemented all of the new criminal background check requirements as of October 1, 2018-its deadline for implementing the requirements. New York...

Rhode Island did not ensure its Medicaid managed-care organizations (MCOs) complied with Federal and State requirements prohibiting Medicaid payments to providers for inpatient hospital services related to treating certain provider-preventable conditions (PPCs). PPCs are certain reasonably...

Some of the bonus payments that Virginia received for the audit period were not allowable in accordance with Federal requirements. Most of the data used in Virginia's bonus payment calculations were in accordance with Federal requirements. However, Virginia overstated its current enrollments in its...

Of the 120 sampled outpatient claims totaling $415,513, First Coast Service Options, Inc. (First Coast) made payments for hyperbaric oxygen (HBO) therapy in accordance with Medicare requirements for 5 claims. However, First Coast made payments for HBO therapy that did not comply with Medicare...

The National Institute of Transplantation (NIT), an independent histocompatibility laboratory located in Los Angeles, California, did not fully comply with Medicare requirements for reporting tissue-typing costs and revenues on its fiscal year (FY) 2012 Medicare cost report. Of the 186 cost...