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Inspector General Reports

Report Datesort ascending Agency Reviewed / Investigated Title Type Location
06/02/2021 Department of Health & Human Services New Mexico Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations Audit US
03/01/2021 Department of Health & Human Services CMS Authorized Hundreds of Millions of Dollars in Advanced Premium Tax Credits on Behalf of Enrollees Who Did Not Make Their Required Premium Payments Audit Agency-Wide
01/27/2021 Department of Health & Human Services Louisiana Did Not Correctly Determine Medicaid Eligibility For Some Newly Enrolled Beneficiaries Audit US
11/10/2020 Department of Health & Human Services Ohio Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries Audit US
10/02/2020 Department of Health & Human Services Colorado Improperly Claimed Millions in Enhanced Federal Medicaid Reimbursement For New Adult Group Beneficiaries Because of a Data Processing Error Audit US
09/01/2020 Department of Health & Human Services Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group Audit US
06/25/2020 Department of Health & Human Services Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2020 Inspection / Evaluation Agency-Wide
03/24/2020 Department of Health & Human Services Most of the Non-Newly Eligible Beneficiaries for Whom Colorado Made Medicaid Payments Met Federal and State Requirements, but Documentation Supporting That All Eligibility Requirements Were Verified Properly Was Not Always in Place Audit Agency-Wide
02/28/2020 Department of Health & Human Services The Centers for Medicare & Medicaid Services Did Not Identify and Report Potential Antideficiency Act Violations for 12 Contracts Used To Establish the Federal Marketplace Under the Affordable Care Act Audit Agency-Wide
02/07/2020 Department of Health & Human Services The Federal Marketplace Properly Determined Individuals' Eligibility for Enrollment in Qualified Health Plans but Improperly Determined That an Estimated 3 Percent of Individuals Were Eligible for Insurance Affordability Programs Audit Agency-Wide
10/21/2019 Department of Health & Human Services Sunshine ACO, LLC, Generally Reported Complete and Accurate Data on Quality Measures Through the CMS Web Portal, but There Were a Few Reporting Deficiencies That Did Not Affect the Overall Quality Performance Score Audit Agency-Wide
08/30/2019 Department of Health & Human Services Colorado Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries Audit CO, US
08/28/2019 Department of Health & Human Services West Florida ACO, LLC, Generally Reported Complete and Accurate Data on Quality Measures Through the CMS Web Portal, but There Were a Few Reporting Deficiencies That Did Not Affect the Overall Quality Performance Score Audit FL, US
08/20/2019 Department of Health & Human Services New York Incorrectly Claimed Enhanced Federal Medicaid Reimbursement for Some Beneficiaries Audit Agency-Wide
08/07/2019 Office of Personnel Management Audit of Pension, Post-Retirement Benefit, and Affordable Care Act Costs for a Sample of BlueCross BlueShield Companies Audit Agency-Wide
07/17/2019 Department of Health & Human Services New York Did Not Correctly Determine Medicaid Eligibility for Some Non-Newly Eligible Beneficiaries Audit Agency-Wide
06/27/2019 Department of Health & Human Services Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2019 Inspection / Evaluation Agency-Wide
04/29/2019 Department of Health & Human Services Medicaid Could Save Hundreds of Millions by Excluding Authorized Generic Drug Transactions to Secondary Manufacturers from Brand Name Drugs’ Average Manufacturer Price Calculations Audit Agency-Wide
04/23/2019 Department of Justice Audit of the Office of Justice Programs Victim Compensation Grants Awarded to the West Virginia Legislative Claims Commission, Charleston, West Virginia Audit WV, US
04/02/2019 Internal Revenue Service Interim Results of the 2019 Filing Season Audit Agency-Wide
02/25/2019 Department of Health & Human Services Factsheet: New Hampshire's Oversight of Opioid Prescribing and Monitoring of Opioid Use Audit NH, US
02/12/2019 Department of Health & Human Services New Mexico Did Not Always Appropriately Refund the Federal Share of Recoveries from Managed Care Organizations Audit NM, US
01/15/2019 Department of Health & Human Services Although the Centers for Medicare & Medicaid Services Has Made Progress, It Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements Audit Agency-Wide
01/04/2019 Department of Health & Human Services Rhode Island Did Not Ensure Its Managed Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions Audit RI, US
12/19/2018 Internal Revenue Service Results of the 2018 Filing Season Audit Agency-Wide
12/17/2018 Department of Health & Human Services Louisiana Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions Audit Agency-Wide
12/13/2018 Department of Health & Human Services Wisconsin Did Not Report and Refund the Full Federal Share of Medicaid-Related Settlements and a Judgment Audit Agency-Wide
12/12/2018 Department of Health & Human Services Texas Claimed Community First Choice Fee-for-Service Expenditures Appropriately Audit Agency-Wide
12/11/2018 Department of Health & Human Services California Made Medicaid Payments on Behalf of Non-Newly Eligible Beneficiaries Who Did Not Meet Federal and State Requirements Audit Agency-Wide
11/30/2018 Department of Health & Human Services Adverse Events in Long-Term-Care Hospitals: National Incidence Among Medicare Beneficiaries Inspection / Evaluation Agency-Wide
11/29/2018 Department of Health & Human Services Corporación Salud Asegurada por Nuestra Organización Solidaria, Inc., a Health Resources and Services Administration Grantee, Generally Complied With Federal Grant Requirements Audit PR, US
11/21/2018 Department of Health & Human Services Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Payments Audit Agency-Wide
10/30/2018 Internal Revenue Service Semiannual Report to Congress Semiannual Report Agency-Wide
10/24/2018 Department of Health & Human Services Ohio Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries’ Deaths Audit Audit Agency-Wide
10/10/2018 Department of Health & Human Services Pennsylvania Generally Complied With Maternal, Infant, and Early Childhood Home Visiting Program Requirements Audit Agency-Wide
10/04/2018 Department of Health & Human Services Ohio Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries’ Deaths Audit Audit OH, US
09/26/2018 Internal Revenue Service Annual Assessment of the Internal Revenue Service’s Information Technology Program for Fiscal Year 2018 Audit Agency-Wide
09/25/2018 Social Security Administration Employers Reporting Wages with Nonwork Social Security Numbers Audit Agency-Wide
09/20/2018 Department of Health & Human Services New York Medicaid Fraud Control Unit: 2017 Onsite Inspection Inspection / Evaluation NY, US
09/20/2018 Internal Revenue Service Controls Continue to Need Improvement to Ensure That All Planned Corrective Actions for Security Weaknesses Are Fully Implemented and Documented Audit Agency-Wide
09/19/2018 Internal Revenue Service Improved Controls Are Needed to Ensure That Corrective Actions for Reported Information Technology Weaknesses Are Documented and Fully Implemented Prior to Closure Audit Agency-Wide
09/17/2018 Department of Health & Human Services Medicare Payments for Clinical Diagnostic Laboratory Tests in 2017: Year 4 of Baseline Data Inspection / Evaluation Agency-Wide
08/08/2018 Department of Health & Human Services CMS Did Not Always Accurately Authorize Financial Assistance Payments to Qualified Health Plan Issuers in Accordance With Federal Requirements During the 2014 Benefit Year Audit Agency-Wide
07/30/2018 Department of Health & Human Services Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity: An OIG Portfolio Inspection / Evaluation Agency-Wide
07/27/2018 Internal Revenue Service Information Technology Investment Management Controls Should Be Better Aligned With the Federal Information Technology Acquisition Reform Act of 2014 Audit Agency-Wide
07/27/2018 Internal Revenue Service Initial Efforts to Develop an Enterprise Case Management Solution Were Unsuccessful; Other Options Are Now Being Evaluated Audit Agency-Wide
06/25/2018 Department of Health & Human Services Virginia Did Not Claim Some Medicaid Administrative Costs for Its Medallion 3.0 Waiver Program In Accordance With Federal Requirements Audit VA, US
05/30/2018 Department of Health & Human Services Texas Made Increased Payments for Services Rendered by Eligible Primary Care Providers Under Federal Requirements Audit TX, US
05/29/2018 Department of Health & Human Services Nevada Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions Audit NV, US
05/23/2018 Internal Revenue Service Programming Errors and Deficiencies in Tax Examiner Screening Resulted in Some Health Coverage Tax Credit Claims Being Erroneously Processed Audit Agency-Wide
05/22/2018 Department of Health & Human Services CMS Did Not Always Provide Accurate Medicaid Unit Rebate Offset Amounts to State Medicaid Agencies Audit Agency-Wide
05/14/2018 Department of Health & Human Services Iowa Complied With Most Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions Audit IA, US
05/14/2018 Department of Health & Human Services Missouri Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions Audit MO, US
05/14/2018 Department of the Treasury FINANCIAL MANAGEMENT: Treasury Did Not Comply with the IPERA Requirements for Fiscal Year 2017 Audit Agency-Wide
05/10/2018 Office of Personnel Management Audit of the Federal Employees Health Benefits Program Operations at Health Alliance Plan 1C-52-00-17-031 Audit Agency-Wide
04/30/2018 Internal Revenue Service Semiannual Report to Congress Semiannual Report Agency-Wide
04/24/2018 Office of Personnel Management Audit of the Federal Employee Health Benefit Program Operation at HealthPlus of Michigan Audit MI, US
04/18/2018 Department of Health & Human Services Colorado Did Not Always Comply With Federal Requirements When Expending Federal Establishment Grant Funds Allocated for Its Shared Eligibility System Costs Audit CO, US
04/13/2018 Department of Health & Human Services Texas Did Not Make Increased Primary Care Provider Payments and Claim Reimbursement in Accordance With Federal Requirements Audit TX, US
04/12/2018 Department of Health & Human Services CMS's Policies and Procedures Were Generally Effective in Ensuring That Prescription Drug Coverage Capitation Payments Were Not Made After the Beneficiaries' Dates of Death Audit Agency-Wide

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