Department of Health & Human Services OIG

The Centers for Medicare & Medicaid Services (CMS) contracted with National Government Services (NGS) to process Part A claims under Medicare contract 00450. CMS requested that we perform an audit of NGS's Medicare Part A final administrative cost proposal for the last three quarters of fiscal years...

The Centers for Medicare & Medicaid Services (CMS) contracted with National Government Services (NGS) to process Part A claims under Medicare contract 00130. CMS requested that we perform an audit of NGS's Medicare Part A final administrative cost proposal for the last three quarters of fiscal years...

The Centers for Medicare & Medicaid Services (CMS) contracted with National Government Services (NGS) to process Part B claims under Medicare contract 00630. CMS requested that we perform an audit of NGS's Medicare Part B final administrative cost proposal for the last three quarters of fiscal years...

Congress has expressed concerns about the safety and well-being of children in foster care. These issues were highlighted in a media report that provided several examples of children who died while in foster care. Additionally, in a recent series of OIG health and safety audits of State-monitored...

Wisconsin Physicians Service Insurance Corporation (WPS) claimed $1.3 million in unallowable administrative costs on its Medicare Part B final administrative cost proposals (FACPs) for fiscal year 2012.

Of the $10.0 million in Low-Income Home Energy Assistance Program (LIHEAP) grant funds that the Administration for Children and Families awarded to the Turtle Mountain Band of Chippewa Indians (TMT) for Federal fiscal years 2010 through 2013, TMT did not administer LIHEAP grant funds totaling $587...

Beginning in 2018, the Medicare program will change the way it sets payment rates for clinical diagnostic laboratory tests (lab tests) under Part B. CMS will replace current payment rates with new rates based on current charges in the private health care market. This is the first reform in 3 decades...

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based...

When Congress established average sales price (ASP) as the basis for Medicare Part B drug reimbursement, it also provided a mechanism for monitoring market prices and limiting potentially excessive payment amounts. The Social Security Act mandates that OIG compare ASPs with average manufacturer...

We determined that Medicare costs related to the replacement of all recalled or prematurely failed medical devices could not be identified and tracked using only Medicare claim data. Such costs cannot be determined using only claim data because, although Medicare claim forms identify the medical...