Department of Health & Human Services OIG

Payments made to providers for specimen validity tests did not comply with Medicare billing requirements. Specifically, Medicare improperly paid 4,480 clinical laboratories and physician offices a total of $66.3 million for specimen validity tests billed in combination with urine drug tests. Centers...

When Arizona billed manufacturers for rebates for pharmacy and physician-administered drugs, it did so correctly. However, Arizona did not bill for and collect from manufacturers estimated rebates of $36.7 million ($25.6 million Federal share) for physician-administered drugs. For drugs that were...

This portfolio presents an overview of program vulnerabilities identified in prior Office of Inspector General audits, evaluations, investigations, and legal actions related to chiropractic services in the Medicare program. It consolidates the findings and issues identified in that work and...

Hyperbaric oxygen therapy (HBO therapy) involves giving a patient high concentrations of oxygen within a pressurized chamber in which the patient intermittently breathes in 100-percent oxygen. A prior Office of Inspector General review identified issues with Medicare payments for HBO therapy. More...

Arkansas did not always comply with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs. Arkansas did not invoice manufacturers for rebates associated with $9.9 million (Federal share) in physician-administered drugs. Of this amount, $8.5 million...

Federal law requires that each Medicare administrative contractor (MAC) have its information security program evaluated annually by an independent entity, and these evaluations must address the eight major requirements enumerated in the Federal Information Security Management Act of 2002 (FISMA). To...

Palmetto Government Benefits Administrator, LLC, claimed unallowable Medicare pension costs of $95,000 for calendar years 2010 and 2011 on its incurred cost proposals.

CGS Administrators, LLC, did not claim allowable Medicare pension costs of $12,000 on its incurred cost proposals for calendar year 2011.

This review is part of a series of hospital compliance reviews. Using computer matching, data mining, and data analysis techniques, we identified hospital claims that were at risk for noncompliance with Medicare billing requirements. For calendar year 2015, Medicare paid hospitals $163 billion...

This report provides the results of our review of the Indian Health Service (IHS) detailed accounting submission, which includes the table of Drug Control Obligations, related disclosures, and management's assertions for the fiscal year ended September 30, 2017. We also reviewed the Performance...