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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

Oregon Properly Verified Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid 

2016
A-09-16-02007
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Oregon Department of Human Services, Office of Licensing and Regulatory Oversight, verified nursing homes' correction of deficiencies identified during surveys in calendar year 2014 in accordance with Federal requirements.

Not All of the Vermont Marketplace's Internal Controls Were Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements 

2016
A-01-14-02507
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Vermont Health Connect's (Vermont marketplace) internal controls were not always effective in ensuring that individuals were enrolled in qualified health plans (QHPs) according to Federal requirements. We identified deficiencies related to verifying applicants' identities, determining eligibility of...

Medicare Compliance Review of Billings Clinic Hospital for 2012 and 2013 

2016
A-07-15-05071
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Billings Clinic Hospital (the Hospital) (operating in Billings, Montana) complied with Medicare billing requirements for 173 of the 179 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining six claims, resulting...

Maryland Claimed Unallowable Costs for Medicaid Communicable Disease Care Services 

2016
A-03-14-00150
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Maryland's Department of Health and Mental Hygiene (State agency) did not always comply with Federal and State requirements when it claimed costs for communicable disease care services. Of the 124 claim lines that we sampled, 49 complied with Federal and State requirements; however, 75 did not. On...

Medicare Compliance Review of Freeman Hospital for 2011 and 2012 

2016
A-07-14-05064
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Freeman Hospital (the Hospital) (operating in Joplin, Missouri) complied with Medicare billing requirements for 180 of the 225 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 45 claims, resulting in...

Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2015

2016
A-18-15-30300
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

Overall, the Department continues to implement changes to strengthen its enterprise-wide information security program. However, opportunities were identified that will allow HHS to continue to enhance its enterprise-wide information security program. We identified several reportable exceptions in...

Public Summary Report: Wireless Penetration Test of Centers for Medicare & Medicaid Services' Data Centers 

2016
A-18-15-30400
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

We performed a wireless penetration test of select Centers for Medicare & Medicaid Services' Data Centers and facilities to determine whether CMS's security controls over its wireless networks were effective.

Texas Inappropriately Received Medicaid Medical Assistance Funding for Some Costs 

2016
A-06-15-00054
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Texas Department of Aging and Disability Services incorrectly claimed approximately $3 million in costs as Medicaid medical assistance expenditures and inappropriately received approximately $570,000 in Federal share.

Texas Inappropriately Claimed Medicaid Balancing Incentive Payments Program and Family Planning Funding 

2016
A-06-14-00059
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The Texas Health and Human Services Commission (State agency) claimed $72.2 million in expenditures that were not related to eligible noninstitutional long-term services and supports and inappropriately received $1.4 million in Balancing Incentive Payments Program funding. Additionally, the State...

Some of New Jersey's Claims for Medicaid Global Options for Long-Term Care Waiver Services Were Unallowable 

2016
A-02-14-01008
Audit
Department of Health & Human Services OIG
Department of Health & Human Services

The New Jersey Department of Human Services (State agency) claimed Federal Medicaid reimbursement for some Global Options for Long-Term Care (GO-LTC) waiver services that did not comply with certain Federal and State requirements. Of the 131 beneficiary-months in our sample, the State agency...

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