Department of Health & Human Services OIG

State Medicaid agencies (Medicaid agencies) are required to suspend payments for health care items and services when there is a credible allegation of fraud against the provider, unless "good cause" exists not to suspend payment. Using payment suspensions, when appropriate, is important to protect...

Statutorily mandated rebates, which include both basic rebates and inflation-indexed rebates (additional rebates owed when drug prices rise faster than inflation), amount to a substantial percentage of spending on Medicaid prescription drugs. Medicare does not have the authority to collect rebates...

When Congress established average sales price (ASP) as the basis for Medicare Part B drug reimbursement, it also provided a mechanism for monitoring market prices and limiting potentially excessive payment amounts. The Social Security Act mandates that OIG compares ASPs with average manufacturer...

Bisphenol-A (BPA), a chemical often used to produce food and drink packaging, has been linked to a variety of adverse health conditions, including cancer. The National Institute of Environmental Health Sciences (NIEHS) funds studies that test substances, including BPA, for carcinogenicity and other...

Medicare spending is expected to grow to $1.4 trillion by 2027. To control this increase and promote quality and healthy populations, the Centers for Medicare & Medicaid Services (CMS) has implemented and is considering a number of alternative payment models that reward providers for the quality and...

OIG administers the Medicaid Fraud Control Unit (MFCU or Unit) grant awards, annually recertifies the Units, and oversees the Units' performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based...

Smoking is the leading cause of preventable disease and death in the United States. In 2009, Congress passed the Family Smoking Prevention and Tobacco Control Act, authorizing FDA to begin regulating tobacco products in the United States. It granted FDA comprehensive authority over domestic tobacco...

Each year, tens of thousands of children without legal status enter the United States unaccompanied by their parents or legal guardians. These children are referred to as unaccompanied alien children (UAC). Between fiscal years 2012 and 2016, the number of UAC entering the United States increased...

Protecting the rights of human subjects-individuals who volunteer to participate in research-is critical to ensuring their safety and public confidence in research conducted or supported by the Department of Health and Human Services (HHS). OHRP enforces compliance with HHS regulations for...

Opioid abuse and overdose deaths are at epidemic levels in the United States. This data brief is part of a larger strategy by the OIG to fight the opioid crisis and address one of its top priority outcomes-to protect beneficiaries from prescription drug abuse. It provides baseline data on the extent...