Department of Health & Human Services OIG

University of Florida Health Jacksonville (the Hospital) complied with Medicare billing requirements for 133 of the 154 inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 21 claims, resulting in net overpayments of $64,000...

Mayo Clinic Florida (the Hospital) complied with Medicare billing requirements for 185 of the 199 inpatient and outpatient claims that we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 14 claims, resulting in net overpayments totaling $71...

Administrative costs received by the Blue Cross Blue Shield Association on its FYs 2010 through 2015 FACPs were generally reasonable, allowable, and allocable and in compliance with Federal regulations. However, we identified $161,000 in unspent termination funds, a $7,000 severance benefit...

The Nebraska Department of Health and Human Services (State agency) claimed Federal Medicaid reimbursement for some nonemergency medical transportation (NET) services claims submitted by NET providers that did not comply with Federal and State requirements during fiscal years (FYs) 2012 through 2014...

In our previous audits of six Medicare contractors, we found that payments made to providers for hospital outpatient dental services generally did not comply with Medicare requirements. Of the 600 dental services in our 6 stratified random samples, 542 did not comply with Medicare requirements. We...

The Texas Health and Human Services Commission did not always claim Federal Medicaid reimbursement for managed care payments in compliance with Federal requirements. Of the 3,170 beneficiary matches in our review, 3,045 were assigned more than 1 Medicaid identification number. As a result, the State...

New York claimed Federal Medicaid reimbursement for partial hospitalization services claims that did not comply with Federal and State requirements. Specifically, of the 100 claims in our random sample, 59 claims complied with Federal and State requirements, but 41 claims did not. The deficiencies...

The New Jersey Department of Human Services (State agency) budgeted Disaster Relief Act funds under its Home Repair and Advocacy Program (HRAP) subaward to Ocean County that were appropriate. However, the State agency claimed some Disaster Relief Act costs under its HRAP subaward to Ocean County...

Overall, in comparison to the prior year's FISMA review, the Department has made improvements. Specifically, the number of findings have decreased from year to year. In addition, the Department and its operating divisions have implemented continuous monitoring tools that have allowed them to gain...

The University of California at Riverside's (the University) prior effort-reporting system did not always provide the information needed to confirm that payroll costs had been appropriately allocated to Federal awards, and its current payroll certification system pilot (pilot PCS) provided less...