Department of Health & Human Services OIG

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 onsite reviews of all Units and prepares public reports...

Medicare hospice care is intended to help terminally ill beneficiaries continue life with minimal disruptions and to support beneficiaries' families and other caregivers. Two key requirements of the Medicare hospice benefit are for the beneficiary to sign an election statement and for a physician to...

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...

The Department of Health and Human Services (HHS) OIG is the designated Federal agency that oversees State Medicaid Fraud Control Units (MFCU or Unit). This MFCU Fiscal Year (FY) 2015 Annual Report highlights statistical achievements from the investigations and prosecutions the 50 MFCUs conducted...

As required by statute, Medicare sets payment amounts for drugs infused through durable medical equipment (DME infusion drugs) at 95 percent of the average wholesale prices (AWPs) in effect on October 1, 2003. AWPs, which represent list prices rather than actual marketplace prices, have been long...

Five States received almost $475 million in Social Services Block Grant funding to help cover social service and reconstruction expenses resulting directly from Superstorm Sandy. When Congress made funds available to States to help pay for their Superstorm Sandy-related expenses, it noted that such...

The Head Start program is the largest Federal investment in early childhood education. The Improving Head Start for School Readiness Act of 2007 required ACF to begin awarding 5-year grants for Head Start and to require grantees that ACF determines are not providing a high-quality and comprehensive...

OIG oversees all State Medicaid Fraud Control Units (MFCUs or Units). As part of this oversight, OIG conducts periodic reviews of all Units and prepares public reports based on these reviews. These reviews assess the Units' adherence to the 12 MFCU performance standards and compliance with...

Medicare Administrative Contractors (MACs) are responsible for reviewing Part B outpatient drug claims to ensure that Medicare pays for drugs that meet the criteria for coverage. Each MAC determines whether a particular use for a given drug, such as a use not approved by the Food and Drug...

Disruptions, such as natural disasters or technical malfunctions, can make electronic health records (EHRs) unavailable to hospital staff. Prior OIG work found, for example, that hospitals experienced substantial challenges responding to the effects of Superstorm Sandy, which included damage to...