Washington, DC—America's taxpayers could see nearly $5.9 billion in misspent Medicare, Medicaid, and other health and human service program dollars … [Read more...]
Texas Did Not Ensure That Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions
10-21-2019 | Audit (A-06-16-01001) | Complete Report | Report in Brief Why OIG Did This Review Federal regulations effective July 1, 2011, prohibit … [Read more...]
The Minnesota State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries’ Deaths
10-01-2019 | Audit (A-05-17-00049) | Complete Report | Report in Brief We estimated that Minnesota made unallowable capitation payments totaling at … [Read more...]
HHS-OIG Releases Latest Quarterly Report
TDMR received an email update from the Texas Health and Human Services Office of Inspector General this week. Although regular quarterly reports have … [Read more...]
OIG Asks for Extra $10M, More ‘Boots on the Ground’ to Target Home- and Community-Based Fraud
The Office of the Inspector General (OIG) is making good on its long-held promise to ramp up oversight of home- and community-based services, … [Read more...]
HHSC OIG Orthodontic Consultant Reluctant to “Second Guess” Xerox/Conduent Prior Authorizations
A board certified orthodontist hired by HHSC-OIG was apparently reluctant to "second guess" Xerox/Conduent prior authorization (PA) approvals per a … [Read more...]
“I Guess No One Really Cares” – HHSC OIG Director of Medicaid Integrity
In the same Xerox/Conduent court filing from July 2018 mentioned in our previous article, there is another exhibit worth mentioning. It is the … [Read more...]
OIG: Texas Improperly Collected $20.7M In Federal Medicaid Money, Owes CMS
Texas overcharged the federal government for a portion of primary care reimbursement following a state Medicaid rate cut, according to the HHS Office … [Read more...]
The top 10 management and performance challenges facing the Department of Health and Human Services
If he’s confirmed as the next secretary of the Department of Health and Human Services, Alex Azar will have his hands full. The Office of Inspector … [Read more...]
