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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

High Part D Spending on Opioids and Substantial Growth in Compounding Drugs Raise Concerns

2016
OEI-02-16-00290
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

Since the Part D program went into effect in 2006, the Office of Inspector General (OIG) has had ongoing concerns about abuse and diversion of Part D drugs. In June 2015, OIG released a data brief, Questionable Billing and Geographic Hotspots Point to Potential Fraud and Abuse in Medicare Part D...

Changing How Medicare Pays for Clinical Diagnostic Laboratory Tests: An Update on CMS's Progress

2016
OEI-09-16-00100
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

Clinical diagnostic laboratory (lab) tests provide information integral to preventing, diagnosing, and treating disease in millions of Medicare beneficiaries every year. The Protecting Access to Medicare Act of 2014 (PAMA) requires reform of Medicare's payment system for lab tests-the first such...

Performance Data for the Senior Medicare Patrol Projects: June 2016 Performance Report

2016
OEI-02-16-00190
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

This memorandum report presents performance data for the Senior Medicare Patrol (SMP) projects, which receive grants from ACL to recruit and train retired professionals and other senior citizens to recognize and report instances or patterns of health care fraud. OIG has collected these performance...

Massachusetts State Medicaid Fraud Control Unit: 2015 Onsite Review

2016
OEI-07-15-00390
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

The Office of Inspector General (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...

Indian Health Service Hospitals: More Monitoring Needed to Ensure Quality Care

2017
OEI-06-14-00010
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

We conducted this study and its companion, Indian Health Service Hospitals: Longstanding Challenges Warrant Focused Attention to Support Quality Care (OEI 06 14 00011), in response to concerns about the care provided in IHS hospitals. Reports of inadequate health care services for American Indians...

Escalating Medicare Billing for Ventilators Raises Concerns

2016
OEI-12-15-00370
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

CMS has expressed concerns about the recent substantial increase in Medicare billing for noninvasive pressure support ventilators. Ventilator technology has evolved so that it is possible for a single device to treat numerous conditions by operating in several different modes-i.e., basic continuous...

State Efforts to Exclude 340B Drugs from Medicaid Managed Care Rebates

2016
OEI-05-14-00430
Inspection / Evaluation
Department of Health & Human Services OIG
Department of Health & Human Services

Manufacturer rebates for drugs paid through Medicaid managed care organizations (MCOs) are an increasingly important source of savings for both States and the Federal government. However, "duplicate discounts," which occur when manufacturers pay Medicaid rebates on drugs sold at the already...

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