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🎥 This week: HHS-OIG announces a major fraud fighting partnership in Ohio and releases new reports showing widespread, systemic problems in Medicare Advantage prior authorization. Watch now!
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OIG at HHS
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OIG at HHS
@OIGatHHS
This is the official X account of the U.S. Department of Health & Human Services Office of Inspector General. Verification: oig.hhs.gov/social-media
- HHS‑OIG joined federal, state, & private partners at the revitalized Northern District of NY Health Care Fraud Task Force meeting. Together, we’re strengthening collaboration to combat health care fraud & protect patients and taxpayer dollars. More: direc.to/fW6y
- Ahold Delhaize USA Inc. has agreed to pay $40 million to resolve allegations that it violated the False Claims Act and state analogs by reporting inflated “usual and customary” prices on claims to federal health care programs. Read more: direc.to/fW69
- HHS-OIG found that CMS included noncovered self‑administered drug versions in ASP-based Part B payment calculations for 4 drugs. CMS must now determine whether to exclude these versions in future quarters to reduce payments. Read more: direc.to/fW63
- Federal indictments in Ohio charge multiple individuals with smuggling unaccompanied children, fraud, and abuse of the unaccompanied alien children sponsorship process. Read more: direc.to/fW6f
- HHS‑OIG just released two reports: one shows the three largest Medicare managed care companies denied long‑term and rehab hospital care at some of the highest rates; the other flags troubling skilled nursing care denials. Read more: direc.to/fW5R
- HHS-OIG just released two reports, the first found that the 3 largest Medicare managed care companies denied enrollees long term & rehab hospital care at the highest rates & showed concerning managed care skilled nursing denials. Read more: direc.to/fW5o
- New OIG audit finds that California claimed at least $13.9M more in Medicaid reimbursements for clinical diagnostic lab services than allowed under federal and state requirements. Learn more: direc.to/fW5k
- A new audit found that none of the 100 sampled prior authorization denials by Community Behavioral Health met federal or state requirements—raising concerns about delayed or denied behavioral health care for Medicaid enrollees. Read more: direc.to/fWZr
- Two Miami women have been charged for allegedly orchestrating a years-long scheme to buy and sell stolen Medicare beneficiary information from thousands of patients for use in Medicare fraud schemes. Learn more: direc.to/fWYB
- HHS-OIG maintains a list of individuals & entities excluded from federally funded health care programs. Anyone who hires an excluded individual or entity may be subject to civil monetary penalties. View the updated May 2026 list: direc.to/fhfe
- New HHS-OIG Audit: ORR did not conduct many monitoring visits as required at care providers serving unaccompanied alien children. ORR missed opportunities to identify providers’ noncompliance with employee background check requirements. Learn more: direc.to/fWZa
- Individuals and entities that wish to disclose evidence of potential fraud to HHS-OIG may do so under the Health Care Fraud Self-Disclosure Protocol. View the most recent and past self-discourses by visiting direc.to/fWYP
