DHS -Office of Inspector General

Friday, December 5, 2025

Latest:

Eileen Cook September 25, 2025September 25, 2025 CMS, DHS -Office of Inspector General, Fail to report, Falls, medicare, Nursing Homes, Older Adults

Nursing homes fail to report 43% of most serious falls: HHS

(By: Elizabeth Gregerson for Becker’s Hospital Review) Nursing homes failed to report 43% of falls that resulted in major injury

CMS DHS -OIG Digital Technology HHS Medical Technology Medicare - General Medicare Advantage

Eileen Cook August 29, 2025August 29, 2025 CMS, DHS -Office of Inspector General, HHS, medicare, Medicare Advantage, Remote Patient Monitoring

Billing for Remote Patient Monitoring in Medicare

In 2024, Medicare paid $536 million for remote patient monitoring, a 31 percent increase from 2023. Remote patient monitoring (RPM)

DHS -OIG Medicare - General

Eileen Cook August 28, 2025August 28, 2025 Against Medical Advice, DHS -Office of Inspector General, medicare

More Medicare patients leaving hospitals against medical advice

(By: Paige Twenter for Becker’s Hospital Review) The rate of Medicare enrollees leaving acute care hospitals against medical advice increased 46%

DHS -OIG HHS Medicaid Prior Authorization

Eileen Cook August 8, 2025August 8, 2025 DHS -Office of Inspector General, HHS, MCOs, Medicaid, Prior Authorization

Prior Authorization Process Policies in Medicaid Managed Care: Findings from a Survey of State Medicaid Programs

(By Jada Raphael, Elizabeth Hinton, Aimee Lashbrook, and Kathleen Gifford for The Kaiser Family Foundation Published: Aug 07, 2025) Medicaid

CMS DHS -OIG HHS Hospice/Home Health Services Medicare Advantage

Eileen Cook November 8, 2024November 8, 2024 CMS, DHS -Office of Inspector General, Home Health Services, Medicare Advantage, Older Adults

Watchdog Calls for Tighter Scrutiny of Medicare Advantage Home Visits

(By Fred Schulte for KFF Health News) A new federal watchdog audit is ratcheting up pressure on government officials to

CMS DHS -OIG Health Care Finance Medicare Advantage

Eileen Cook October 25, 2024October 24, 2024 CMS, DHS -Office of Inspector General, Health Risk Assessments, Healthcare Finance, Medicare Advantage, Older Adults

Medicare Advantage: Questionable Use of Health Risk Assessments Continues To Drive Up Payments to Plans by Billions

(Source – oig.hhs.gov) Medicare Advantage (MA) companies receive higher risk-adjusted payments from the Centers for Medicare & Medicaid Services (CMS)

CMS DHS -OIG HHS Medicare Advantage Prior Authorization

Eileen Cook July 8, 2024 CMS, Deny Post-Acute Care, DHS -Office of Inspector General, Medicare Advantage, Medicare Advantage Prior Authorization

OIG to probe whether Medicare Advantage plans deny post-acute care

(By Rylee Wilson for Becker’s Hospital Review) HHS’ Office of Inspector General will audit Medicare Advantage plans’ use of prior

CMS DHS -OIG Health Care Finance Medicare Advantage

Eileen Cook December 5, 2023December 5, 2023 CMS, DHS -Office of Inspector General, Healthcare Costs, Healthcare Finance, Medicare Advantage, Medicare Advantage Audits, Medicare Advantage Overpayments

10 payers audited for Medicare Advantage overpayments in 2023

(By Rylee Wilson for Becker’s Hospital Review) OIG audits found over $213 million in estimated Medicare Advantage overpayments in 2023.

DHS -OIG Medicare Advantage

Eileen Cook December 4, 2023December 4, 2023 CMS, DHS -Office of Inspector General, Medicare Advantage, Medicare Advantage Overpayments

OIG: Centene subsidiary received estimated $5.1M in Medicare Advantage overpayments

(By Rylee Wilson for Becker’s Hospital Review) SelectCare of Texas, a Centene subsidiary, received an estimated $5.1 million in net

← Previous