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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

Ariel Foundation Against Pediatric AIDS Managed and Expended the President's Emergency Plan for AIDS Relief Funds in Accordance with Award Requirements 

2017
A-04-16-04052
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Congress authorized the President's Emergency Plan for AIDS Relief (PEPFAR) to receive $48 billion in funding for the 5-year period beginning October 1, 2008, to assist foreign countries in combating HIV/AIDS, tuberculosis, and malaria. Congress authorized additional funds to be appropriated through...

Management and Development for Health Did Not Always Manage the President's Emergency Plan for AIDS Relief Funds in Accordance With Award Requirements 

2017
A-04-16-04045
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Congress authorized the President's Emergency Plan for AIDS Relief (PEPFAR) to receive $48 billion in funding for the 5-year period beginning October 1, 2008, to assist foreign countries in combating HIV/AIDS, tuberculosis, and malaria. Congress authorized additional funds to be appropriated through...

Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did Not Comply With Federal Requirements 

2017
A-05-14-00047
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Health Information Technology for Economic and Clinical Health Act established the Medicare and Medicaid electronic health record (EHR) incentive programs to promote the adoption of EHRs and to improve health care quality, safety, and efficiency through the promotion of health information...

Review of Wisconsin Medicaid Managed Care Program Potential Savings With Minimum Medical Loss Ratio 

2017
A-05-15-00040
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

We determined that the Wisconsin Medicaid program could have saved $16.2 million (approximately $9.6 million Federal share) in 2014 if Wisconsin (1) required its Medicaid managed care plans to meet the minimum medical loss ratio (MLR) standard similar to the Federal standards for certain private...

Louisiana Complied With the Requirements of the Social Security Act in Its Review of Cases of Credible Allegations of Medicaid Fraud 

2017
A-06-16-00010
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The State agency complied with the requirements of the Social Security Act when it received a credible allegation of fraud by its Medicaid providers.

Texas Did Not Always Ensure That Allegations and Referrals of Abuse and Neglect of Children Eligible for Title IV-E Foster Care Payments Were Recorded and Investigated in Accordance With Federal and State Requirements 

2017
A-06-15-00049
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Texas Department of Family and Protective Services (State agency) did not always ensure that allegations and referrals of abuse and neglect for children in foster care covered by Title IV-E of the Act were recorded and investigated in accordance with Federal and State requirements. Of the 100...

Medicare Could Save Millions by Eliminating the Lump-Sum Purchase Option for All Power Mobility Devices 

2017
A-05-15-00020
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

In the future, Medicare could save millions if the Centers for Medicare & Medicaid Services (CMS) seeks legislation to eliminate the lump-sum payment option and requires all power mobility devices (PMDs) be provided to beneficiaries on a monthly rental basis.

Public Summary Report: Virginia Did Not Adequately Secure Its Medicaid Data 

2017
A-04-15-05066
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

This summary report provides an overview of the results of our audit of the information security controls over Virginia's Medicaid Management Information System (MMIS). It does not include specific details of the vulnerabilities that we identified because of the sensitive nature of the information...

HHS Did Not Identify and Report Antideficiency Act Violations 

2017
A-03-13-03002
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Program Support Center (PSC) obligated and expended funds for 17 of the 30 contracts we reviewed in accordance with appropriations law and Federal acquisition requirements; however, for the remaining 13 contracts, the PSC did not always obligate and expend funds for its contracts in compliance...

Kentucky Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries 

2017
A-04-15-08044
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Kentucky did not always determine Medicaid eligibility in accordance with Federal and State requirements. Of our sample of 120 beneficiaries, Kentucky correctly determined eligibility for 111 beneficiaries, but it did not determine eligibility for the remaining 9 beneficiaries in accordance with...

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