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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

Oklahoma Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals 

2016
A-06-15-00032
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Oklahoma Health Care Authority (State agency) did not always pay electronic health record (EHR) incentive program payments to eligible hospitals in accordance with Federal and State requirements for program years 2011 and 2012. Specifically, the State agency overpaid seven hospitals a total of...

New Jersey Made Incorrect Medicaid Electronic Health Record Incentive Payments 

2016
A-02-14-01009
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The New Jersey Department of Human Services (State agency) did not always pay electronic health record (EHR) incentive payments in accordance with Federal and State requirements. The State agency made incorrect EHR incentive payments to 15 hospitals totaling $2.5 million. Specifically, the State...

A Kansas Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Physical Therapy Services 

2016
A-07-14-01146
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

A Kansas physical therapy practice (the Therapy Practice) claimed Medicare reimbursement for some outpatient physical therapy services that did not meet Medicare reimbursement requirements. Of the 100 beneficiary days in our random sample, the Therapy Practice properly claimed Medicare reimbursement...

Kansas Correctly Invoiced Rebates to Manufacturers for Most Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations 

2016
A-07-15-06060
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Although the Kansas Department of Health and Environment, Division of Health Care Finance (State agency) generally complied with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs dispensed to enrollees of Medicaid managed-care organizations (MCOs)...

Medicare Compliance Review of Home Health VNA for 2011 and 2012 

2016
A-01-13-00518
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Home Health VNA (the Agency) (located in Lawrence, Massachusetts) did not comply with Medicare billing requirements for 105 of the 497 home health claims we reviewed. As a result, the Agency received net overpayments of $314,000 for calendar years 2011 and 2012. Specifically, the Agency incorrectly...

The Department Of Health And Human Services Security Management Practices For Computer Systems With Access To Personally Identifiable Information 

2016
A-18-16-30150
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Cybersecurity Act of 2015 (Cybersecurity Act) requires the Inspector General of each covered agency to collect and report to Congress information about the covered agency's covered systems within 240 days of the enactment of the Cybersecurity Act. A covered agency is an agency that operates a...

State Governments May Unduly Benefit Financially From Publicly Owned but Privately Operated Entities 

2016
A-06-16-08005
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

During our audit of the Alabama Medicaid Agency's (State agency) hospital certified public expenditures (CPEs) program for fiscal year (FY) 2010, we noticed that the State agency had claimed, for FYs 2010 and 2011, more than $5 million in Federal funds related to CPEs for three hospitals that...

Colorado Received Millions in Unallowable Bonus Payments 

2016
A-04-15-08039
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Under the Children's Health Insurance Program Reauthorization Act of 2009, Congress appropriated $3.225 billion for qualifying States to receive performance bonus payments (bonus payments) for Federal fiscal years (FYs) 2009 through 2013 to offset the costs of increased enrollment of children in...

Pennsylvania Made Correct Medicaid Electronic Health Record Incentive Payments to Hospitals 

2016
A-03-15-00403
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

From January 1, 2011 to June 30, 2014, the Pennsylvania Department of Health and Human Resources, Department of Medical Assistance Services (the State agency), made approximately $287.4 million for Medicaid Electronic Health Record incentive payments. Of this amount, $158.1 million was paid to 136...

West Virginia Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals 

2016
A-03-14-00406
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

From July 1, 2011, through December 31, 2013, the West Virginia Department of Health and Human Resources, Department of Medical Assistance Services (the State agency) paid $50.3 million to 42 eligible hospitals in West Virginia for Medicaid electronic health record (ERD) incentive payments. We...

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