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Date Issued
Submitting OIG
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-06-18-02001
Report Type
Audit
Agency Wide
Yes
Number of Recommendations
2
Questioned Costs
$551,917
Funds for Better Use
$0
Report updated under NDAA 5274
No
External Link
https://oig.hhs.gov/documents/audit/10010/A-06-18-02001.pdf

Open Recommendations

This report has 2 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
24-A-06-109.01 No $551,917 $0

We recommend that EmblemHealth refund to the Federal Government the $551,917 of net overpayments.

24-A-06-109.02 No $0 $0

We recommend that EmblemHealth continue to ensure that its policies and procedures have been adequately designed and implemented to prevent, detect, and correct noncompliance with Federal requirements for diagnosis codes that are used to calculate risk-adjusted payments.

Department of Health & Human Services OIG

United States