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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

Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Managerial Retirement Program for Selected Locations

2018
A-07-17-00517
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Wisconsin Physicians Service Insurance Corporation understated its Medicare segment pension assets as of December 31, 2009, by $33,000.

Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Managerial Pension Plan

2018
A-07-17-00518
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Wisconsin Physicians Service Insurance Corporation understated its Medicare segment pension assets as of December 31, 2013, by $3.2 million.

Texas Did Not Appropriately Spend Some State Balancing Incentive Payments Program Funds

2018
A-06-15-00041
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Texas Health and Human Services Commission (State agency) did not always calculate supplemental payments made to the Texas Tech University (TTU) health institutions in accordance with Federal and State requirements. Specifically, the supplemental payment calculations included overstated Medicare...

Georgia Made Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid Identification Numbers

2018
A-04-16-07061
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Georgia made capitation payments on behalf of beneficiaries who were assigned multiple Medicaid identification (ID) numbers. Of the 100 beneficiary matches in our sample, Georgia correctly claimed reimbursement for capitation payments on behalf of 28. However, Georgia incorrectly claimed multiple...

Tennessee Managed Care Organizations Received Medicaid Capitation Payments After Beneficiary's Death

2018
A-04-15-06190
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Tennessee did not always stop making capitation payments after a beneficiary's death, despite its efforts to identify and recover any unallowable payments. Of the 120 capitation payments in our random sample selected from payments for beneficiaries whose dates of death (DODs) preceded the payment...

New York Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries

2018
A-02-15-01015
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

New York did not always determine Medicaid eligibility for newly eligible beneficiaries in accordance with Federal and State requirements. In our sample of 130 beneficiaries, New York correctly determined eligibility for 90 beneficiaries. However, it did not determine eligibility for 37...

The Food and Drug Administration's Food-Recall Process Did Not Always Ensure the Safety of the Nation's Food Supply

2018
A-01-16-01502
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Prior Office of Inspector General (OIG) reviews focused on U.S. Food and Drug Administration (FDA) oversight of food recalls. Food recalls are the most effective means of protecting public health when a widely consumed food product is either defective or potentially harmful. At the time of those OIG...

New York Did Not Comply With Federal Grant Requirements for Allocating and Claiming Marketplace Contract Costs

2018
A-02-15-02008
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

New York did not always follow Federal requirements for allocating and claiming contract costs to its grants for establishing New York's marketplace customer service center. Specifically, New York may have misallocated costs totaling nearly $19.6 million and claimed unallowable profit fees and other...

Indiana Did Not Always Comply With Maternal, Infant, and Early Childhood Home Visiting Program Requirements

2018
A-05-16-00056
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Patient Protection and Affordable Care Act of 2010 established the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV program) in 2010, and it was to be collaboratively implemented by HHS's Health Resources and Services Administration and the Administration for Children and...

Texas Did Not Bill Manufacturers for Some Rebates for Pharmacy Drugs of Medicaid Managed-Care Organizations

2018
A-06-16-00004
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Texas did not fully comply with Federal Medicaid requirements for billing manufacturers for some rebates for pharmacy drugs dispensed to managed-care organization enrollees. Texas properly processed claims for rebates in most instances; however, some claims were bypassed in the Drug Rebate Analysis...

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