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What's New

January

01-15-2021
Medicare Home Health Agency Provider Compliance Audit: Southeastern Home Health Services
Updated: Work Plan
01-14-2021
Federal COVID-19 Testing Report: Data Insights from Six Federal Health Programs
Updated: Fraud Risk Indicator
01-13-2021
Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00355
Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00354
Independent Attestation Review: National Institutes of Health Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00352
Independent Attestation Review: Indian Health Service Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions A-03-21-00351
01-08-2021
Updated: Corporate Integrity Agreements
01-07-2021
LEIE Database Updated with December 2020 Exclusions and Reinstatements
Ohio Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program A-05-18-00004
01-05-2021
Updated: Corporate Integrity Agreements

December

12-31-2020
The Centers for Medicare & Medicaid Services Could Improve Its Wage Index Adjustment for Hospitals in Areas With the Lowest Wages 
Advisory Opinion 20-09 (regarding a program where a pharmaceutical manufacturer provides financial assistance for travel, lodging, and other expenses to certain patients prescribed the manufacturer's drug)
12-30-2020
Advisory Opinion 20-08 (regarding a federally qualified health center’s proposal to offer gift cards to incentivize certain pediatric patients to attend rescheduled preventive and early intervention care appointments)
12-29-2020
Updated: Corporate Integrity Agreements
12-28-2020
Advisory Opinion 20-07 (regarding a web-based platform where health care facilities and clinicians would, in particular circumstances, remit to patients and the patients' payors a portion of the claims for certain services for which payment may be made by the Medicare program as a secondary payor)
Medicare Home Health Agency Provider Compliance Audit: Tender Touch Health Care Services A-04-18-07077
States Could Do More to Oversee Spending and Contain Medicaid Costs for Specialty Drugs OEI-03-17-00430
12-23-2020
Advisory Opinion 20-06 (regarding a management company's provision of below fair market value Medicaid enrollment application assistance services to certain individuals and affiliated skilled nursing facilities' payments for those services in particular circumstances)
Aspects of Texas' Quality Incentive Payment Program Raise Questions About Its Ability To Promote Economy and Efficiency in the Medicaid Program A-06-18-07001
12-22-2020
Onsite Surveys of Nursing Homes During the COVID-19 Pandemic: March 23-May 30, 2020 OEI-01-20-00430
Despite Savings on Many Lab Tests in 2019, Total Medicare Spending Increased Slightly Because of Increased Utilization for Certain High-Priced Tests OEI-09-20-00450
12-21-2020
The Office of Refugee Resettlement Did Not Award and Manage the Homestead Influx Care Facility Contracts in Accordance With Federal Requirements A-12-20-20001
Indian Health Service Facilities Made Progress Incorporating Patient Protection Policies, but Challenges Remain OEI-06-19-00331
Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Tullahoma, Tennessee A-02-16-01024
Updated: Corporate Integrity Agreements
12-18-2020
Medicare Hospital Provider Compliance Audit: Providence Medical Center A-07-18-05113
12-16-2020
Opioids in Medicaid: Concerns About Opioid Use Among Beneficiaries in Six Appalachian States OEI-05-19-00410
Medicare Home Health Agency Provider Compliance Audit: Total Patient Care Home Health, LLC A-06-16-05005
HHS Operating Division Needs to Improve Controls Over Key Application to Protect Sensitive Data A-18-19-06002
12-15-2020
Updated: Work Plan
12-14-2020
Incidence of Adverse Events in Indian Health Service Hospitals OEI-06-17-00530
Instances of IHS Labor and Delivery Care Not Following National Clinical Guidelines or Best Practices OEI-06-19-00190
Although CDC Implemented Corrective Actions To Improve Oversight of the President's Emergency Plan for AIDS Relief Recipients, Some Internal Control Weaknesses Remained A-04-18-01010
Risk Assessment Puerto Rico Medicaid Program A-02-20-01011
Updated COVID-19 FAQs
12-11-2020
New York Improved Its Monitoring of Its Personal Care Services Program But Still Made Improper Medicaid Payments of More Than $54 Million A-02-19-01016
12-10-2020
Updated COVID-19 FAQs
LEIE Database Updated with November 2020 Exclusions and Reinstatements
Few Patients Received High Amounts of Opioids from IHS-Run Pharmacies OEI-05-18-00470
The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2019 in Accordance With Federal Requirements A-04-20-04077
12-09-2020
Updated Stipulated Penalties and Exclusion for Material Breach
Updated Provider Self-Disclosure Settlements
Updated Civil Monetary Penalties and Affirmative Exclusions
12-08-2020
New York Provided Projects for Assistance in Transition From Homelessness Grant Services to Ineligible Individuals and Did Not Contribute Any Required Non-Federal Funds A-02-19-02006
12-04-2020
Updated: Corporate Integrity Agreements
12-03-2020
Updated COVID-19 Fraud Alert
12-02-2020
2020 Fall Semiannual Report to Congress
Press Release: HHS-OIG’s Work Could Save Taxpayers Billions of Dollars, New Report Says
Nebraska Claimed Almost All Medicaid Payments for Targeted Case Management Services in Accordance With Federal Requirements but Claimed Some Unallowable Duplicate Payments A-07-19-03239

November

11-27-2020
Florida Received Unallowable Medicaid Reimbursement for School-Based Services A-04-18-07075
11-24-2020
U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement A-17-20-54000
11-23-2020
Opioid Treatment Programs Reported Challenges Encountered During the COVID-19 Pandemic and Actions Taken To Address Them A-09-20-01001
Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Payson, Arizona. A-02-16-01023
Updated COVID-19 Fraud Alert
11-20-2020
Final Rule: Medicare and State Health Care Programs: Fraud and Abuse; Revisions to Safe Harbors under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements
Medicare Home Health Agency Provider Compliance Audit: The Palace at Home A-04-17-07067
Updated: Corporate Integrity Agreements
11-19-2020
Ohio Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00023
Medicare Hospital Provider Compliance Audit: Edward W. Sparrow Hospital A-05-18-00045
11-18-2020
Cahaba Government Benefits Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00577
Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00578
Hospitals Did Not Comply With Medicare Requirements for Reporting Cardiac Device Credits A-01-18-00502
11-17-2020
2020 Top Management and Performance Challenges Facing HHS
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Second Quarter of 2020 OEI-03-21-00050
11-16-2020
Updated: Work Plan
Special Fraud Alert: Speaker Programs
In Selected States, 67 of 100 Health Centers Did Not Use Their HRSA Access Increases in Mental Health and Substance Abuse Services Grant Funding in Accordance With Federal Requirements A-02-19-02001
Updated: Corporate Integrity Agreements
11-12-2020
Ohio Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries A-05-18-00027
Updated: Corporate Integrity Agreements
11-10-2020
Advocating for the Nation's Elder Population: Operation CARE
Updated: Corporate Integrity Agreements
LEIE Database Updated with October 2020 Exclusions and Reinstatements
11-09-2020
Office of Refugee Resettlement Ensured That Selected Care Providers Were Prepared To Respond to the COVID-19 Pandemic A-04-20-02031
11-06-2020
Cahaba Government Benefits Administrators, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00575
Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00576
CMS Did Not Ensure That Medicare Hospital Payments for Claims That Included Medical Device Credits Were Reduced in Accordance With Federal Regulations, Resulting in as Much as $35 Million in Overpayments A-07-19-00560
11-03-2020
Updated: Corporate Integrity Agreements
11-02-2020
Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Central Jersey Home Care and Hospice, Inc. A-02-17-01025
Updated: Corporate Integrity Agreements

October

10-30-2020
Minnesota Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00018
Medicare Hospital Provider Compliance Audit: St Francis Hospital A-05-18-00048
10-27-2020
Updated: Corporate Integrity Agreements
10-26-2020
Updated: Work Plan
Massachusetts Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-06-18-04001
Updated: Corporate Integrity Agreements
10-23-2020
Medicare Home Health Agency Provider Compliance Audit: Gem City Home Care, LLC A-05-18-00011
10-16-2020
Cedars-Sinai Medical Center: Audit of Medicare Payments for Bariatric Surgeries A-09-18-03010
10-15-2020
Updated: Work Plan
10-13-2020
Medicare Improperly Paid Physicians for More Than Five Spinal Facet-Joint Injection Sessions During a Rolling 12-Month Period A-09-20-03003
10-09-2020
Update on Oversight of Opioid Prescribing and Monitoring of Opioid Use: States Have Taken Action To Address the Opioid Epidemic A-09-20-01000
Updated: Fraud Risk Indicator
10-08-2020
LEIE Database Updated with September 2020 Exclusions and Reinstatements
Remarks: 2020 Health Care Fraud Takedown
10-07-2020
Updated: Corporate Integrity Agreements
10-06-2020
HHS Made Some Progress Toward Compliance With the Geospatial Data Act A-18-20-11500
Colorado Improperly Claimed Millions in Enhanced Federal Medicaid Reimbursement for New Adult Group Beneficiaries Because of a Data Processing Error A-07-17-02807
Medicare Critical Care Services Provider Compliance Audit: Clinical Practices of the University of Pennsylvania A-03-18-00003
10-05-2020
Speech: Connecting the Dots: An OIG Update, by Christi A. Grimm, Principal Deputy Inspector General
10-02-2020
Risk Assessment of Food and Drug Administration's Purchase Card Program A-04-19-06234
Medicare Hospital Provider Compliance Audit: Alta Bates Summit Medical Center A-04-19-08071
Updated: Corporate Integrity Agreements
10-01-2020
Updated: Work Plan
National Snapshot of State Agency Approaches to Child Care During the COVID-19 Pandemic A-07-20-06092
Youth For Tomorrow - New Life Center, Inc., an Administration for Children and Families Grantee, Did Not Comply With All Applicable Federal Policies and Requirements A-03-16-00250

September

09-30-2020
2020 National Health Care Fraud Takedown
09-29-2020
FDA's Risk Evaluation and Mitigation Strategies: Uncertain Effectiveness in Addressing the Opioid Crisis OEI-01-17-00510
North Carolina Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-04-16-00112
09-28-2020
Healthcare Dive Op-Ed by Christi A. Grimm: Medicare Advantage should not 'game the system' but prioritize patient care, honest billing
Updated: Corporate Integrity Agreements
09-25-2020
States Continued To Fall Short in Meeting Required Timeframes for Investigating Nursing Home Complaints: 2016-2018 OEI-01-19-00421
09-24-2020
Updated: Corporate Integrity Agreements
Connecticut Did Not Meet Federal and State Requirements for Claiming Medicaid School-Based Child Health Services for Hartford Public Schools A-01-19-00003
CMS's Monitoring Activities for Ensuring That Medicare Accountable Care Organizations Report Complete and Accurate Data on Quality Measures Were Generally Effective, but There Were Weaknesses That Could Be Improved A-09-18-03033
09-23-2020
Advisory Opinion 20-05 (regarding a pharmaceutical manufacturer's proposal to provide cost-sharing assistance directly to Medicare beneficiaries who are prescribed either of two formulations of its drug)
CMS Should Pursue Strategies To Increase the Number of At Risk Beneficiaries Acquiring Naloxone Through Medicaid OEI-BL-18-00360
Arkansas Medicaid Fraud Control Unit: 2019 Onsite Inspection OEI-12-19-00450
Oregon's Oversight Did Not Ensure That Four Coordinated-Care Organizations Complied With Selected Medicaid Requirements Related to Access to Care and Quality of Care A-09-18-03035
Updated: Corporate Integrity Agreements
09-22-2020
North Carolina Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-19-08070
Vermont Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-19-06086
09-21-2020
Updated: Work Plan
Updated: Corporate Integrity Agreements
Illinois Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-05-18-00037
Incorrect Acute Stroke Diagnosis Codes Submitted by Traditional Medicare Providers Resulted in Millions of Dollars in Increased Payments to Medicare Advantage Organizations A-07-17-01176
09-18-2020
Updated: Corporate Integrity Agreements
Medicare-Allowed Charges for Noninvasive Ventilators Are Substantially Higher Than Payment Rates of Select Non-Medicare Payers A-05-20-00008
Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals A-07-20-00590
09-17-2020
Southwest Key Programs Failed To Protect Federal Funds Intended for the Care and Placement of Unaccompanied Alien Children A-06-17-07004
Indiana Did Not Ensure That Medicaid Payments Were Made Properly for Some Claims Identified as Having Third-Party Coverage A-05-18-00046
Medicare Home Health Agency Provider Compliance Audit: Mercy Health Visiting Nurse Services A-05-18-00035
09-16-2020
Maine Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-18-06079
Group Health Incorporated Overstated Its Allowable Medicare Supplemental Executive Retirement Plan Costs for Calendar Years 2009 Through 2016 A-07-19-00582
Group Health Incorporated Claimed Some Unallowable Medicare Postretirement Benefit Costs for Calendar Years 2009 Through 2016  A-07-19-00583
09-15-2020
Updated: Work Plan
Group Health Incorporated Overstated Its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of December 31, 2015 A-07-19-00579
Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of August 31, 2016 A-07-19-00580
Group Health Incorporated Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2009 Through 2016 A-07-19-00581
Some Manufacturers Reported Inaccurate Drug Product Data to CMS OEI-03-19-00200
09-14-2020
The National Institutes of Health Should Improve Its Stewardship and Accountability Over Hardware and Software Assets A-18-19-06004
09-11-2020
Baylor Scott & White—College Station: Audit of Outpatient Outlier Payments A-06-18-04003
09-10-2020
LEIE Database Updated with August 2020 Exclusions and Reinstatements
Billions in Estimated Medicare Advantage Payments From Diagnoses Reported Only on Health Risk Assessments Raise Concerns OEI-03-17-00471
Updated: Provider Self-Disclosure Settlements
09-09-2020
Updated Civil Monetary Penalties and Affirmative Exclusions
Audit of Medicare Part D Pharmacy Fees: Horizon Blue Cross Blue Shield, Inc. A-03-18-00007
09-04-2020
Hawaii's Monitoring Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements A-09-19-01000
National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded in 2019 OEI-07-20-00180
09-03-2020
Updated COVID-19 FAQs
Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group A-07-19-02822
Medicare Hospital Provider Compliance Audit: Flagstaff Medical Center A-07-18-05112
09-02-2020
Tribal Health Programs: Concerns About Background Verifications for Staff Working With Indian Children A-01-20-01500
CMS Generally Met Requirements for the DMEPOS Competitive Bidding Program Round 1 Recompete A-05-16-00051
09-01-2020
Indiana's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 17 of 30 Providers Reviewed A-05-19-00012
Michigan Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00017
Illinois Claimed Unallowable Telemedicine Payments  A-05-18-00028
Indiana Paid $3.5 Million for Medicaid Nonemergency Medical Transport Claims That Did Not Comply With Federal and State Requirements A-05-18-00043

August

08-31-2020
Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria Fiscal Year 2021 Inspectors General Coordinated PEPFAR Oversight Plan U.S. Department of Health and Human Services, Office of Inspector General  A-04-20-01017
08-28-2020
Updated: Work Plan
Texas Relied on Impermissible Provider-Related Donations To Fund the State Share of the Medicaid Delivery System Reform Incentive Payment Program A-06-17-09002
08-27-2020
Medicare Contractors Were Not Consistent in How They Reviewed Extrapolated Overpayments in the Provider Appeals Process A-05-18-00024
08-26-2020
Updated: Work Plan
CMS's Encounter Data Lack Essential Information That Medicare Advantage Organizations Have the Ability to Collect OEI-03-19-00430
08-25-2020
Indiana Properly Reported Adjustments Related to the Drug Rebate Program A-05-19-00028
08-24-2020
Updated: Corporate Integrity Agreements
08-21-2020
Rhode Island's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 18 of 30 Providers Reviewed A-01-18-02505
Updated: Corporate Integrity Agreements
08-20-2020
Updated: Fraud Risk Indicator
New Jersey Did Not Ensure That Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries Residing in Nursing Facilities Were Always Properly Investigated and Reported  A-02-18-01006
08-18-2020
Nebraska Claimed Unallowable School-Based Administrative Costs Because of Improper Coding of Random Moment Timestudy Responses A-07-19-03234
Medicare Home Health Agency Provider Compliance Audit: Mission Home Health of San Diego, Inc.  A-09-18-03008
08-17-2020
Updated: Work Plan
Opioid Use in Medicare Part D Continued To Decline in 2019, but Vigilance Is Needed as COVID-19 Raises New Concerns OEI-02-20-00320
Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2018 Average Sales Prices OEI-03-20-00130
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2020 OEI-03-20-00060
08-14-2020
Medicare Laboratory Test Expenditures Increased in 2018, Despite New Rate Reductions  (OEI-09-19-00100)
08-12-2020
Visionquest Industries, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03010
Medicare Home Health Agency Provider Compliance Audit: Condado Home Care Program, Inc. A-02-17-01022
08-11-2020
OIG's Top Unimplemented Recommendations: Solutions To Reduce Fraud, Waste, and Abuse in HHS Programs
08-10-2020
Desoto Home Health Care, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03021
08-07-2020
Inadequate Edits and Oversight Caused Medicare To Overpay More Than $267 Million for Hospital Inpatient Claims With Post-Acute-Care Transfers to Home Health Services A-04-18-04067
08-06-2020
LEIE Database Updated with July 2020 Exclusions and Reinstatements
Some Nursing Homes' Reported Staffing Levels in 2018 Raise Concerns; Consumer Transparency Could Be Increased OEI-04-18-00450
Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2019 A-18-20-11300
Updated: Corporate Integrity Agreements
08-05-2020
Updated: Provider Self-Disclosure Settlements
Updated: Corporate Integrity Agreements
08-04-2020
Updated COVID-19 FAQs
08-03-2020
Emergency Response Toolkits: Key Insights and Lessons Learned

July

07-31-2020
North Carolina Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse and Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Timely A-04-17-04063
07-30-2020
Kansas Did Not Ensure That Group Homes for Children in Foster Care Complied With All State Health and Safety Requirements A-07-19-06087
Factsheet: Ohio's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-05-19-00036
UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
07-29-2020
The New York State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-04-19-06223
07-28-2020
New Jersey's Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 9 of 30 Providers Reviewed A-02-19-02004
07-27-2020
Updated: Work Plan
Updated Corporate Integrity Agreements
07-24-2020
Utah's Monitoring Process Generally Ensured Child Care Provider Compliance With State Criminal Background Check Requirements A-07-19-06085
On-Site Psychological Services, P.C.: Audit of Medicare Payments for Psychotherapy Services A-02-19-01012
Alaska Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-09-19-02001
Advisory Opinion 20-04 (regarding a charitable organization's proposal to purchase or receive donations of unpaid medical debt owed by qualifying patients from certain types of health care providers and then forgive that debt)
Updated Corporate Integrity Agreements
07-23-2020
CMS Could Have Saved $192 Million by Targeting Home Health Claims for Review With Visits Slightly Above the Threshold That Triggers a Higher Medicare Payment A-09-18-03031
HRSA's Monitoring Did Not Always Ensure Health Centers' Compliance With Federal Requirements for HRSA's Access Increases In Mental Health and Substance Abuse Services Supplemental Grant Funding A-02-18-02010
07-22-2020
FY 2019 Health Care Fraud and Abuse Control Program Report
07-16-2020
CMS Did Not Administer and Manage Strategic Communications Services Contracts in Accordance With Federal Requirements A-12-19-20003
Ohio Did Not Ensure the Accuracy and Completeness of Psychotropic and Opioid Medication Information Recorded in Its Child Welfare Information System for Children in Foster Care A-05-18-00007
07-15-2020
Updated: Work Plan
Hospitals Overbilled Medicare $1 Billion by Incorrectly Assigning Severe Malnutrition Diagnosis Codes to Inpatient Hospital Claims A-03-17-00010
Updated Corporate Integrity Agreements
07-14-2020
Medicaid Data Can Be Used To Identify Instances of Potential Child Abuse or Neglect  A-01-19-00001
07-13-2020
Texas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-04003
Updated Corporate Integrity Agreements
07-10-2020
LEIE Database Updated with June 2020 Exclusions and Reinstatements
Sharon Baptist Head Start Claimed Unallowable Rent and Failed To Return Embezzled Funds A-02-17-02003
07-09-2020
Updated Corporate Integrity Agreements
07-08-2020
Freedom Orthotics, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03012
Loophole in Drug Payment Rule Continues To Cost Medicare and Beneficiaries Hundreds of Millions of Dollars OEI-BL-20-00100
Updated: Fraud Risk Indicator
Updated: Provider Self-Disclosure Settlements
07-07-2020
2019 Performance Data for the Senior Medicare Patrol Projects OEI-02-20-00150
Updated Corporate Integrity Agreements
07-02-2020
Updated Corporate Integrity Agreements
Updated: Work Plan
07-01-2020
Advisory Opinion 20-03 (regarding an arrangement under which a discount medical plan organization ("DMPO") pays chiropractors and chiropractic clinics a fee for each new DMPO member referred by the chiropractor or chiropractic clinic)

June

06-30-2020
Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2020 OEI-05-20-00190
06-26-2020
Hawaii Medicaid Fraud Control Unit: 2019 Onsite Review OEI-06-19-00110
Updated: Fraud Risk Indicator
06-23-2020
Updated: Work Plan
06-19-2020
Updated Corporate Integrity Agreements
06-18-2020
Unaccompanied Alien Children Program Care Provider Facilities Do Not Include All Required Security Measures in Their Checklists OEI-05-19-00210
The Office of Refugee Resettlement's Incident Reporting System Is Not Effectively Capturing Data To Assist Its Efforts To Ensure the Safety of Minors in HHS Custody OEI-09-18-00430
Press Release: HHS-OIG: Significant Incidents Involving Unaccompanied Children Not Effectively Captured in Reporting System; Facility Physical Security Inspection Checklists Need Improvement
View a timeline detailing OIG's national review of the UAC Program
06-15-2020
Updated Stipulated Penalties and Exclusion for Material Breach
Updated: Work Plan
06-10-2020
LEIE Database Updated with May 2020 Exclusions and Reinstatements
Updated Provider Self-Disclosure Settlements
06-09-2020
Updated Corporate Integrity Agreements
06-08-2020
Texas Telemedicine Services Were Provided in Accordance with State Requirements A-06-18-05001
Medicare Hospital Provider Compliance Audit: The Ohio State University Hospital A-05-18-00042
06-05-2020
HHS Should Address Gaps in Incident Response Capabilities Across the Department A-18-17-04002
06-04-2020
Updated Corporate Integrity Agreements
06-03-2020
The National Cancer Institute Needs To Strengthen Procedures in Its Pre-Award Process To Assess Risk for Higher Risk Applicants A-03-19-03004
New Jersey Did Not Ensure That Its Managed Care Organizations Adequately Assessed and Covered Medicaid Beneficiaries' Needs for Long-Term Services and Supports A-02-17-01018
06-01-2020
Spring 2020 Semiannual Report to Congress

May

05-28-2020
Updated Corporate Integrity Agreements
05-27-2020
The National Eye Institute Generally Had Adequate Procedures To Assess an Applicant's Risk During the Pre-Award Process A-05-19-00017
05-26-2020
COVID-19 Response Strategic Plan
Opening Statement for Christi Grimm, Principal Deputy Inspector General, Office of Inspector General, U.S. House Committee on Oversight and Reform: Oversight Related to Coronavirus Response Efforts
05-22-2020
Updated: Work Plan
Updated Corporate Integrity Agreements
05-14-2020
UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
05-13-2020
Updated Corporate Integrity Agreements
05-12-2020
U.S. Department of Health and Human Services Met Many Requirements of the Improper Payments Information Act of 2002 but Did Not Fully Comply for Fiscal Year 2019 A-17-20-52000
05-08-2020
LEIE Database Updated with April 2020 Exclusions and Reinstatements
UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
HHS Operating Division Needs to Improve Security Controls to More Effectively Prevent Cyberattacks A-18-18-08400
05-07-2020
HHS OIG Toolkits for Calculating Opioid Levels and Identifying Patients At Risk of Misuse or Overdose
Medicare Part D Beneficiaries at Serious Risk of Opioid Misuse or Overdose: A Closer Look OEI-02-19-00130
Updated Provider Self-Disclosure Settlements
05-06-2020
Updated Corporate Integrity Agreements
05-05-2020
Illinois' Monitoring Did Not Ensure Childcare Provider Compliance With State Criminal Background Check Requirements at 12 of 30 Providers Reviewed A-05-19-00016
Medicare Made $11.7 Million in Overpayments for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays A-01-17-00508
05-04-2020
Selected Health Care Coalitions Increased Involvement in Whole Community Preparedness But Face Developmental Challenges Following New Requirements in 2017 OEI-04-18-00080
05-01-2020
North Carolina Received $30 Million in Excess Federal Funds Related to Improperly Claimed Health Home Expenditures A-04-18-00120
UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency

April

04-30-2020
Updated Corporate Integrity Agreements
Updated Civil Monetary Penalties and Affirmative Exclusions
04-28-2020
Updated: Work Plan
04-24-2020
UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
04-23-2020
UPDATED: FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
04-22-2020
Grand Desert Psychiatric Services: Audit of Medicare Payments for Psychotherapy Services A-09-19-03018
Recommendation Followup: Michigan Did Not Report and Refund the Full Federal Share of Medicaid Overpayments A-05-18-00022
04-21-2020
Grants, Contracts, and Other Agreements: Fraud and Abuse; Information Blocking; Office of Inspector General's Civil Money Penalty Rules
Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs A-07-20-00589
Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Pension Costs A-07-20-00588
Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00587
Palmetto Government Benefits Administrator, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00586
HHS Operating Division Needs to Improve Information Technology Continuity Planning A-18-18-04005
04-20-2020
Cape Cod Child Development Program Did Not Meet Its Head Start Non-Federal Share Obligations A-01-19-02500
Updated Corporate Integrity Agreements
04-17-2020
Updated Corporate Integrity Agreements
04-15-2020
Mississippi Needs To Improve Oversight of Its Child Care Payment Program A-07-18-04111
96 Percent of South Carolina's Medicaid Fee-for-Service Telemedicine Payments Were Insufficiently Documented or Otherwise Unallowable A-04-18-00122
Updated Corporate Integrity Agreements
Updated: Work Plan
04-14-2020
Medicare Home Health Agency Provider Compliance Audit: Residential Home Health A-05-16-00063
Updated Corporate Integrity Agreements
04-13-2020
An Estimated 87 Percent of Inpatient Psychiatric Facility Claims With Outlier Payments Did Not Meet Medicare's Medical Necessity or Documentation Requirements A-01-16-00508
Most Indian Health Service Purchased/Referred Care Program Claims Were Not Reviewed, Approved, and Paid in Accordance With Federal Requirements 
04-10-2020
LEIE Database Updated with March 2020 Exclusions and Reinstatements
04-09-2020
New York Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-02-18-01016
Iowa Inadequately Monitored Its Medicaid Health Home Providers, Resulting in Tens of Millions in Improperly Claimed Reimbursement A-07-18-04109
Updated Fraud Risk Indicator
04-07-2020
Updated Corporate Integrity Agreements
Updated Provider Self-Disclosure Settlements
Updated CIA Reportable Events
Updated: Work Plan
04-06-2020
Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 23-27, 2020 OEI-06-20-00300
The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2018 in Accordance With Federal Requirements A-04-19-04072
Review of the Department of Health and Human Services' Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2019 A-18-19-11200
New Hampshire's Monitoring Did Not Ensure Childcare Provider Compliance With State Criminal Background Check Requirements at 21 of 30 Providers Reviewed A-01-18-02504
04-03-2020
OIG Policy Statement Regarding Application of Certain Administrative Enforcement Authorities Due to Declaration of Coronavirus Disease 2019 (COVID-19) Outbreak in the United States as a National Emergency
FAQs–Application of OIG's Administrative Enforcement Authorities to Arrangements Directly Connected to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency
NIH Has Acted To Protect Confidential Information Handled by Peer Reviewers, But It Could Do More OEI-05-19-00240
04-01-2020
States Could Do More To Prevent Terminated Providers From Serving Medicaid Beneficiaries OEI-03-19-00070
Twenty-Three States Reported Allowing Unenrolled Providers To Serve Medicaid Beneficiaries OEI-05-19-00060

March

03-31-2020
New York's Oversight of Medicaid Managed Care Organizations Did Not Ensure Providers Complied With Health and Safety Requirements at 18 of 20 Adult Day Care Facilities Reviewed A-02-18-01027
Medicare Hospital Provider Compliance Audit: Forbes Hospital A-03-18-00005
Updated Civil Monetary Penalties and Affirmative Exclusions
Updated CIA Reportable Events
03-30-2020
OIG Strategic Plan 2020–2025
Message from leadership on minimizing burdens on providers
Iowa Did Not Comply With Federal and State Requirements for Major Incidents Involving Medicaid Members With Developmental Disabilities A-07-18-06081
03-27-2020
At A Glance: Medicaid Fraud Control Units Fiscal Year 2019 Annual Report
Medicare Dialysis Services Provider Compliance Review: Bio-Medical Applications of Arecibo, Inc. A-02-17-01016
Risk Assessment of HHS Grant Closeout Procedures A-04-19-08072
Updated Corporate Integrity Agreements
03-26-2020
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 A-07-18-02812
Office of Counsel inquiries should be directed to officeofcounsel@oig.hhs.gov
03-24-2020
FAQ: Waiving Telehealth Cost-Sharing During COVID-19 Outbreak
Florida Made Almost $4 Million in Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid ID Numbers A-04-18-07080
Updated Corporate Integrity Agreements
03-23-2020
Fraud Alert: COVID-19 Scams
Montana Medicaid Fraud Control Unit: 2019 Onsite Inspection OEI-12-19-00170
Updated: Work Plan
03-20-2020
Updated Corporate Integrity Agreements
03-19-2020
CMS Could Take Actions To Help States Comply With Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions  A-09-18-02004
03-18-2020
States' Use of Grant Funding for a Targeted Response to the Opioid Crisis OEI-BL-18-00460
03-17-2020
Waiving Telehealth Cost-Sharing During COVID-19 Outbreak
Missouri Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-07-18-03230
03-16-2020
The National Institutes of Health Has Controls to Mitigate the Risk That Grantees Receive Duplicate Grant Funding A-02-19-02002
Updated Corporate Integrity Agreements
Updated Civil Monetary Penalties and Affirmative Exclusions
Updated: Work Plan
03-11-2020
Updated Corporate Integrity Agreements
03-10-2020
LEIE Database Updated with February 2020 Exclusions and Reinstatements
Factsheet: Kentucky's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-04-19-02022
SAMHSA's Oversight of Accreditation Bodies for Opioid Treatment Programs Did Not Comply With Some Federal Requirements A-09-18-01007
Key Medicare Tools To Safeguard Against Pharmacy Fraud and Inappropriate Billing Do Not Apply to Part D OEI-02-15-00440
Florida Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-18-08065
03-09-2020
Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Third Quarter of 2019 OEI-03-20-00040
03-05-2020
Communication and Management Challenges Impeded HHS's Response to the Zero-Tolerance Policy OEI-BL-18-00510
Press Release: HHS OIG: Communication and Management Challenges Impeded HHS's Response to Zero-Tolerance Policy
03-04-2020
Medicare Hospital Provider Compliance Audit: Saint Francis Health Center A-07-17-05102
Updated Provider Self-Disclosure Settlements
03-03-2020
New Mexico's Monitoring of Childcare Providers Generally Ensured Provider Compliance With State Criminal Background Check Requirements at 30 Childcare Providers Reviewed A-06-19-07001
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 A-03-16-03001
Updated Corporate Integrity Agreements
03-02-2020
CHI St. Vincent Infirmary: Audit of Outpatient Outlier Payments A-06-16-01002
National Institutes of Health Had Information Technology Control Weaknesses Surrounding Its Electronic Health Record System A-18-19-06003

February

02-27-2020
Testimony of Suzanne Murrin, Deputy Inspector General, Office of Evaluation and Inspections, Office of Inspector General, U.S. House Committee on Appropriations, Subcommittee on Agriculture, Rural Development, Food and Drug Administration, and Related Agencies: Oversight of the Food and Drug Administration
02-26-2020
Ownership—But Not Physical Movement—of Selected Drugs Can Be Traced Through the Supply Chain OEI-05-17-00460
New York Made Unallowable Payments Totaling More Than $10 Million for Managed Care Beneficiaries Assigned Multiple Medicaid Identification Numbers A-02-18-01020
New York Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-02-18-01011
02-24-2020
OCIG Job Posting: Senior Counsel for Exclusions
(Washington, DC)
- Deadline 02/28/2020
02-21-2020
Updated Corporate Integrity Agreements
02-20-2020
Michigan Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-05-17-00048
02-18-2020
Opportunities for Williamson and Burnet Counties Had Ineffective Accounting Controls and Used Unapproved or Questionable Cost Allocation Methods A-06-18-02002
Updated: Work Plan
02-14-2020
The Majority of Providers Reviewed Used Medicare Part D Eligibility Verification Transactions for Potentially Inappropriate Purposes A-05-17-00020
Georgia's Monitoring of Childcare Providers Ensured Provider Compliance With State Criminal Background Check Requirements A-04-19-03580
02-13-2020
The Indiana State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-05-19-00007
Wateree Community Actions, Inc., Made Improvements but Still Requires Monitoring A-04-19-08069
New York Followed Its Approved Methodology for Claiming Enhanced Medicaid Reimbursement Under the Community First Choice Option A-02-17-01015
02-12-2020
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 A-09-18-01000
02-10-2020
FY 2021 Congressional Budget Justification
LEIE Database Updated with January 2020 Exclusions and Reinstatements
Life Safety and Emergency Preparedness Deficiencies Found at 18 of 20 Texas Nursing Homes A-06-19-08001
Job Opening: Associate Counsel for Exclusions (Washington, DC)
02-06-2020
New York Claimed Tens of Millions of Dollars for Opioid Treatment Program Services That Did Not Comply With Medicaid Requirements Intended To Ensure the Quality of Care Provided to Beneficiaries A-02-17-01021
Updated Provider Self-Disclosure Settlements
02-04-2020
Missouri Medicaid Fraud Control Unit: 2018 Onsite Inspection OEI-12-18-00490
02-03-2020
Geographic Disparities Affect Access to Buprenorphine Services for Opioid Use Disorder OEI-12-17-00240

January

01-30-2020
More Than One-Third of New Jersey's Federal Medicaid Reimbursement for Providing Community-Based Treatment Services Was Unallowable A-02-17-01020
01-29-2020
Medicare Market Shares of Diabetes Test Strips From April Through June 2019  OEI-04-19-00481
01-27-2020
The National Institutes of Health Submitted OIG Clearance Documents for Just Over One-Half of Its Audit Recommendations, and the Remaining 225 Recommendations Were Unresolved as of September 30, 2016 A-07-19-03236
CMS's Implementation of a 2014 Policy Change Resulted in Improvements in the Reporting of Coverage Gap Discounts Under Medicare Part D A-07-16-06067
Tennessee's Monitoring Ensured Compliance With Criminal Background Check Requirements at 28 of the 30 Childcare Providers Reviewed A-04-19-02023
01-24-2020
Advisory Opinion 20-02 (regarding financial assistance for travel, lodging, and other expenses provided by a pharmaceutical manufacturer to certain patients prescribed the manufacturer's drug)
01-23-2020
Updated Corporate Integrity Agreements
01-22-2020
Pennsylvania Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-03-17-00202
Updated Corporate Integrity Agreements
Updated Civil Monetary Penalties and Affirmative Exclusions
01-17-2020
Florida's Refugee Medical Assistance Payments Were Generally Allowable A-04-18-02010
Novitas Solutions, Inc. Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances  A-06-17-04002
Letter to Office of Management and Budget Director to Meet Requirements of Government Charge Card Abuse Prevention Act of 2012 Regarding Agency Progress Implementing Recommendations on Charge-Card-Related Findings A-04-19-06232
01-16-2020
CMS's Controls Over Assigning Medicare Beneficiary Identifiers and Mailing New Medicare Cards Were Generally Effective but Could Be Improved in Some Areas A-09-19-03003
01-15-2020
Updated Corporate Integrity Agreements
Updated: Work Plan
01-14-2020
New York Improperly Claimed Medicaid Reimbursement for Some Bridges to Health Waiver Program Services That Were Not in Accordance With an Approved Plan of Care and Did Not Meet Documentation Requirements A-02-18-01003
01-13-2020
Advisory Opinion 20-01 (regarding a hospital's provision of discounted training to a specified fire department's personnel at the hospital's facility)
01-10-2020
LEIE Database Updated with December 2019 Exclusions and Reinstatements
Updated Provider Self-Disclosure Settlements
01-06-2020
Updated Corporate Integrity Agreements
01-03-2020
Updated Corporate Integrity Agreements