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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

Kentucky Misallocated Millions to Establishment Grants for a Health Insurance Marketplace 

2017
A-04-14-07050
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Cabinet for Health and Family Services (State agency) did not allocate costs for establishing a health insurance marketplace to its establishment grants in accordance with Federal requirements.

Newark Preschool Council, Inc., Did Not Always Comply With Head Start Requirements 

2017
A-02-14-02024
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Newark Preschool Council, Inc. (Newark), which operated throughout Newark, New Jersey, did not always comply with Head Start program requirements, resulting in its receiving approximately $10 million of excess Head Start funds during a 17-month period. In addition, it did not monitor its partner...

Vidant Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition 

2017
A-03-15-00011
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Vidant Medical Center (the Hospital), in Greenville, North Carolina, complied with Medicare billing requirements for diagnosis codes 261 and 262 for 11 of the 100 claims that we reviewed. However, the Hospital did not comply with Medicare billing requirements for the remaining 89 claims. For two of...

CDC Awarded Selected Ebola Funds for International Response Activities in Accordance With Applicable Laws, Regulations, and Departmental Guidance 

2017
A-04-16-03568
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Centers for Disease Control and Prevention awarded all 31 selected Ebola-related international grants totaling $122 million in accordance with applicable laws, regulations, and departmental guidance.

Puerto Rico's Controls for Its Child Care and Development Program Claims Were Not Effective 

2017
A-02-13-02005
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Not all of the Commonwealth of Puerto Rico's Department of the Family's (State agency) controls for provider and client eligibility determinations were effective. Specifically, all of the provider eligibility controls we tested for provider background checks, required provider forms, and provider...

New York Claimed Medicaid Reimbursement for Unallowable Dental Services Billed by a Dentist Based in Queens 

2017
A-02-13-01034
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The New York State Department of Health claimed Federal Medicaid reimbursement for dental services billed by a Queens dentist that did not always comply with certain Federal and State requirements. Of the 100 randomly selected beneficiaries that we reviewed, claims associated with 67 beneficiaries...

New York Claimed Medicaid Reimbursement for Unallowable Dental Services Billed by a Dentist Based in Westchester County 

2017
A-02-13-01033
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The New York State Department of Health claimed Federal Medicaid reimbursement for dental services billed by a Westchester County dentist that did not always comply with certain Federal and State requirements. Of the 100 randomly selected beneficiaries that we reviewed, claims associated with 78...

Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2015 

2017
A-18-16-30300
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

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...

New Jersey Should Strengthen Hurricane Sandy Social Services Block Grant Internal Controls 

2017
A-02-14-02010
Disaster Recovery Report
Department of Health & Human Services OIG
Department of Health & Human Services

On the basis of our review of 41 subrecipients, we determined that the New Jersey Department of Human Services (State agency) budgeted appropriate costs and claimed Sandy Social Services Block Grant costs that were in accordance with Federal requirements as of March 31, 2014. However, the State...

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

2017
A-09-15-02025
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

For the nine Medicaid managed-care organizations (MCOs) we reviewed, the Medicaid program would not have realized savings in 2014 if the California Department of Health Care Services (State agency) had required its MCOs to meet a minimum medical loss ratio (MLR) standard, similar to the Federal...

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