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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
Department of Health & Human Services
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2020
U.S. Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for Fiscal Year 2020
The Office of Inspector General (OIG) must review the Department of Health and Human Services' (HHS's) compliance with the Payment Integrity Information Act of 2019 (PIIA, P.L. No. 116-117) and related applicable improper payment guidance. Ernst & Young (EY), LLP, under its contract with the HHS OIG, audited the fiscal year (FY) 2020 HHS improper payment information reported in the Agency Financial Report (AFR) to determine compliance with PIIA and related guidance from the Office of Management and Budget (OMB).
This report recaps OIG achievements in FY2020, in core mission as well as organizational improvements. It contains a spotlight on our CARES Act work and highlights key statistical impacts from OIG.
The Medicare hospice benefit allows providers to claim Medicare reimbursement for hospice services provided to individuals with a life expectancy of 6 months or less who have elected hospice care. Previous OIG audits and evaluations found that Medicare inappropriately paid for hospice services that did not meet certain Medicare requirements.Our objective was to determine whether hospice services provided by Alive Hospice, Inc. (Alive), complied with Medicare requirements.
The Medicare hospice benefit allows providers to claim Medicare reimbursement for hospice services provided to individuals with a life expectancy of 6 months or less who have elected hospice care. Previous OIG audits and evaluations found that Medicare inappropriately paid for hospice services that did not meet certain Medicare requirements.Our objective was to determine whether hospice services provided by Ambercare Hospice, Inc. (Ambercare), complied with Medicare requirements.
