CGS Administrators, LLC, Did Not Reopen and Recalculate Most Selected Hospices' Caps for Years Prior to 2020

Date Issued

Wednesday, November 27, 2024

Submitting OIG

Department of Health & Human Services OIG

Agencies Reviewed/Investigated

Department of Health & Human Services

Report Number

A-06-23-09003

Report Type

Audit

Agency Wide

Yes

Number of Recommendations

Questioned Costs

Funds for Better Use

Report updated under NDAA 5274

External Link

Open Recommendations

This report has 3 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
25-A-06-020.01	No	$0	$0
We recommend that CGS Administrators, LLC discontinue its practices that limit the reopening of prior years' cap calculations and start reopening all prior years' cap calculations.
25-A-06-020.02	No	$0	$0
We recommend that CGS Administrators, LLC revise its policies and procedures so that it meets the reopening deadlines established in Federal requirements.
25-A-06-020.03	No	$0	$0
We recommend that CGS Administrators, LLC conduct the prior years' hospice cap calculations for the five hospices with UPIC recoupments and collect any additional overpayments.