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Website
https://oig.hhs.gov/
Abbreviation
HHSOIG
Agencies
Department of Health & Human Services
Federal Agency
Yes
Location

United States

What to Report to the OIG Hotline
The U.S. Department of Health and Human Services (HHS) Office of Inspector General's (OIG) mission is to protect the integrity of HHS programs as well as the health and welfare of program beneficiaries. In doing so, we rely on complaints by HHS employees, contractors, subcontractors, grantees and subgrantees (i.e. whistleblowers) who report fraud, waste, abuse or mismanagement in HHS programs. We also review and investigate reports of whistleblower retaliation. If you would like more information on what kinds of complaints our OIG investigates, please visit our website at https://oig.hhs.gov/fraud/report-fraud/before-you-submit.asp. There you will find a list of things you should know before submitting a complaint to the OIG. If you would like more information on the types of whistleblowers protected by the OIG, please visit our whistleblower protection page at https://oig.hhs.gov/fraud/report-fraud/whistleblower.asp. If you are a whistleblower and wish to report fraud, waste, abuse or mismanagement in HHS programs, or you wish to report whistleblower retaliation, please visit our Hotline at https://oig.hhs.gov/fraud/report-fraud/index.asp.
What Not to Report to the OIG Hotline
  • Issues about Medicare policy, coverage, billing claims or appeals
  • Lost or stolen Medicare card
  • Allegations by HHS employees of discrimination on the basis of race, gender, ethnicity, religion or sexual preference
  • Allegations by employees or applicants concerning prohibited personnel practices; or Hatch Act violations
  • Appeals of administrative decisions made by HHS agencies, grantees or contractors, including Medicare payment decisions and contract or grant awards
  • Appeals of judicial decisions by federal or state courts involving HHS programs
  • Complaints of failure to safeguard medical information, i.e. HIPAA violations
  • Customer service complaints involving HHS employees, grantees or contractors
  • Allegations of identity theft unrelated to HHS programs
  • Disability fraud
  • SNAP/Food Stamp Fraud
  • Self-Disclosures
Hotline Page
https://oig.hhs.gov/fraud/report-fraud/index.asp
Whistleblower Protection Page
https://oig.hhs.gov/fraud/whistleblower/?utm_source=oig-home&utm_medium=oig-gfx…

The Penobscot Indian Nation Did Not Meet All Federal and Tribal Health and Safety Requirements

2019
A-01-17-01502
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Penobscot Indian Nation (Penobscot Nation) did not meet all Federal and Tribal health and safety requirements for the quality of health care at the Penobscot Nation Health Department (PNHD). Specifically, we found that PNHD did not have a physician who provided the medical direction for the...

Vulnerabilities Exist in State Agencies' Use of Random Moment Sampling To Allocate Costs for Medicaid School-Based Administrative and Health Services Expenditures

2019
A-07-18-04107
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Inadequate oversight at both the Centers for Medicare & Medicaid Services (CMS) and the State Medicaid agency (State agency) level created vulnerabilities in State agencies' use of random moment timestudies (RMTS) as a basis to allocate and claim Federal Medicaid reimbursement for costs associated...

The Centers for Medicare & Medicaid Services Had Not Recovered More Than a Billion Dollars in Medicaid Overpayments Identified by OIG Audits

2019
A-05-17-00013
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

In a previous review, OIG determined that CMS had recovered the majority of Medicaid overpayments that we had identified in audit reports issued during Federal fiscal years (FYs) 2000 through 2009. However, millions of dollars remained uncollected at the time we issued our report. We performed the...

Summary of Security Vulnerabilities Identified at Two Arizona Managed Care Organizations and Inconsistent Treatment of Medicaid Data Security at the State Agency and Managed Care Organizations

2019
A-18-17-09302
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The HHS OIG's reviews of information system general controls at two Medicaid managed care organizations (MCOs) in Arizona identified numerous security vulnerabilities. The Arizona Health Care Cost Containment System administers Arizona's Medicaid program and is the State agency responsible for...

Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Payments

2019
A-01-17-00500
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

We observed significant vulnerabilities in the wage index system while conducting 41 reviews of hospitals' wage data, with reports issued from 2004 through 2017. CMS uses area wage indexes to adjust hospital payments annually to reflect local labor prices. CMS calculates each area's wage index based...

The Tornillo Influx Care Facility: Concerns About Staff Background Checks and Number of Clinicians on Staff

2019
A-12-19-20000
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The memorandum was issued in response to two significant vulnerabilities identified by OIG during a site visit to the influx care facility in Tornillo, Texas (Tornillo), a grantee of the Unaccompanied Alien Children (UAC) Program operated by the Office of Refugee Resettlement (ORR). Specifically...

The Centers for Disease Control and Prevention Has Controls and Strategies To Mitigate Hurricane Preparedness and Response Risk

2019
A-04-18-02014
Disaster Recovery Report
Department of Health & Human Services OIG
Department of Health & Human Services

Our objectives were to identify CDC’s potential risks for preparing for and responding to hurricanes and other natural disasters and to determine whether CDC has designed and implemented controls and strategies to mitigate these potential risks.

National Government Services, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs

2019
A-07-18-00552
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

National Government Services, Inc., did not claim $1.1 million of allowable Medicare postretirement benefit costs on its Final Administrative Cost Proposals for fiscal years 2010 through 2013.

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