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1. Data inadequacies undermine CMS's oversight of the inconsistency resolution process for the federal marketplace

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, March 2017
Subject(s):
Data Collection
Eligibility Determination
Health Insurance Exchanges
Cost Sharing
Federal Government
Government Regulation
Humans
United States
United States. Department of Health and Human Services.
United States.
Centers for Medicare & Medicaid Services (U.S.)

2. CMS validated hospital inpatient quality reporting program data, but should use additional tools to identify gaming

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, April 2017
Subject(s):
Economics, Hospital
Insurance, Health, Reimbursement
Quality Indicators, Health Care
Reimbursement, Incentive
Cross Infection
Inpatients
Mandatory Reporting
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

4. CDC generally met its inspection goals for the federal select agent program: however, opportunities exist to strengthen oversight

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, May 2017
Subject(s):
Government Regulation
Security Measures
Toxins, Biological
Federal Government
Laboratories -- standards
Risk Assessment
Risk Management
Humans
United States
United States. Department of Health and Human Services.
Centers for Disease Control and Prevention (U.S.)

6. Round 2 competitive bidding for CPAP/RAD: disrupted access unlikely for devices, inconclusive for supplies

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, June 2017
Subject(s):
Competitive Bidding
Continuous Positive Airway Pressure -- economics
Continuous Positive Airway Pressure -- instrumentation
Durable Medical Equipment -- economics
Health Services Accessibility -- economics
Insurance Coverage -- economics
Insurance, Health, Reimbursement
Medicare -- economics
Respiration, Artificial -- economics
Respiration, Artificial -- instrumentation
Humans
United States
United States. Department of Health and Human Services.

8. OHRP generally conducted its compliance activities independently, but changes would strengthen its independence

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, July 2017
Subject(s):
Human Experimentation -- standards
Patient Rights
Research Subjects
Ethics Committees, Research
Guideline Adherence
Human Experimentation -- ethics
Humans
United States
United States. Department of Health and Human Services.
United States. Department of Health and Human Services. Office for Human Research Protections.

9. HHS's Office of Refugee Resettlement improved coordination and outreach to promote the safety and well-being of unaccompanied alien children

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, July 2017
Subject(s):
Child Welfare
Emigrants and Immigrants
Emigration and Immigration
Refugees
Child
Child Abuse -- prevention & control
Human Trafficking -- prevention & control
Safety
Humans
United States
United States. Department of Health and Human Services.
United States. Department of Homeland Security.

10. Medicare program shared savings accountable care organizations have shown potential for reducing spending and improving quality

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2017
Subject(s):
Accountable Care Organizations
Cost Savings
Cost Sharing
Medicare
Quality of Health Care
Cost Control
Facilities and Services Utilization -- statistics & numerical data
Fee-for-Service Plans
Health Expenditures
Quality Indicators, Health Care
Humans
United States
United States. Department of Health and Human Services.

13. As funding for BPA research increased, NIEHS followed its peer review process while also exercising its discretion

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2017
Subject(s):
Peer Review
Phenols -- adverse effects
Research -- economics
Federal Government
Financing, Government
Humans
United States
United States. Department of Health and Human Services.
National Institutes of Health (U.S.)

15. Medicare Part B drug payments: impact of price substitutions based on 2014 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2017
Subject(s):
Drug Costs
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services
Medicare Part B -- economics
Cost Savings
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

17. Drug supply chain security: wholesalers exchange most tracing information

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Pharmaceutical Preparations -- supply & distribution
Prescription Drug Diversion
Information Dissemination
Security Measures
Humans
United States
United States. Department of Health and Human Services.
United States. Food and Drug Administration.

22. Enhancements needed in the tracking and collection of Medicare overpayments identified by ZPICS and PSCS

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Financial Audit
Insurance, Health, Reimbursement
Medicare -- economics
Contract Services
Durable Medical Equipment -- economics
Home Care Services -- economics
Hospice Care -- economics
Information Dissemination
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

23. A few states fell short in timely investigation of the most serious nursing home complaints: 2011-2015

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Nursing Homes
Quality Assurance, Health Care
Aged
Elder Abuse
State Government
Time Factors
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

25. Medicare Part B drug payments: impact of price substitutions based on 2015 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Drug Costs
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services
Medicare -- economics
Cost Savings
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

26. Medicare payments for clinical diagnostic laboratory tests in 2016: year 3 of baseline data

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2017
Subject(s):
Clinical Laboratory Techniques -- economics
Insurance, Health, Reimbursement
Medicare Part B -- economics
Prospective Payment System
Rate Setting and Review
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

27. Excluding noncovered versions when setting payment for two Part B drugs would have resulted in lower drug costs for Medicare and its beneficiaries

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, November 2017
Subject(s):
Drug Costs
Insurance, Pharmaceutical Services -- economics
Medicare Part B -- economics
Prospective Payment System
Abatacept -- economics
Certolizumab Pegol -- economics
Cost Savings
Injections -- economics
Self Care -- economics
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)
Healthcare common procedure coding system

28. Medicaid Fraud Control Units: investigation and prosecution of fraud and beneficiary abuse in Medicaid personal care services

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, December 2017
Subject(s):
Fraud -- prevention & control
Homemaker Services
Medicaid
Elder Abuse
Government Regulation
State Government
Humans
United States
United States. Department of Health and Human Services.

29. Followup review: CMS's management of the quality payment program

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, December 2017
Subject(s):
Insurance, Health, Reimbursement
Medical Informatics
Medicare Part B -- economics
Quality of Health Care -- economics
Reimbursement, Incentive
Diffusion of Innovation
Fraud -- prevention & control
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

30. Potential misclassifications reported by drug manufacturers may have led to $1 billion in lost Medicaid rebates

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, December 2017
Subject(s):
Drug Costs
Drug Industry -- economics
Medicaid -- economics
Pharmaceutical Preparations -- classification
Pharmaceutical Preparations -- economics
Insurance, Health, Reimbursement
Insurance, Pharmaceutical Services
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

31. Entities' experiences and perceptions of reporting the theft, loss, or release of select agents or toxins to CDC

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, February 2018
Subject(s):
Biohazard Release
Mandatory Reporting
Toxins, Biological
Laboratories
Organizational Culture
Safety
Theft
Humans
United States
United States. Department of Health and Human Services.
Centers for Disease Control and Prevention (U.S.)

32. Drug supply chain security: dispensers received most tracing information

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, March 2018
Subject(s):
Pharmaceutical Preparations -- supply & distribution
Prescription Drug Diversion
Drug Industry
Information Dissemination
Pharmacies
Security Measures
Humans
United States
United States. Department of Health and Human Services.

34. Round two competitive bidding for oxygen: continued access for vast majority of beneficiaries

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, May 2018
Subject(s):
Competitive Bidding
Durable Medical Equipment -- economics
Health Services Accessibility
Insurance, Health, Reimbursement
Medicare -- economics
Oxygen Inhalation Therapy -- economics
Fraud -- prevention & control
Humans
United States
United States. Department of Health and Human Services.

35. Round two competitive bidding for enteral nutrition: continued access for vast majority of beneficiaries

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, May 2018
Subject(s):
Competitive Bidding
Durable Medical Equipment -- economics
Enteral Nutrition -- economics
Health Services Accessibility
Insurance, Health, Reimbursement
Medicare -- economics
Fraud -- prevention & control
Humans
United States
United States. Department of Health and Human Services.

36. HRSA helped health centers with elevated risks and can continue to take additional steps

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, May 2018
Subject(s):
Financing, Government
Health Facilities -- economics
Medically Underserved Area
Health Services Accessibility -- economics
Quality of Health Care
Risk Management
Humans
United States
United States. Department of Health and Human Services.
United States. Health Resources and Services Administration.

38. Part D plans generally include drugs commonly used by dual eligibles: 2018

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, June 2018
Subject(s):
Drug Utilization
Dual MEDICAID MEDICARE Eligibility
Formularies as Topic
Medicare Part D
Insurance Benefits
Insurance, Pharmaceutical Services
Humans
United States
United States. Department of Health and Human Services.
United States.

40. Entities generally met Federal Select Agent Program internal inspection requirements, but CDC could do more to improve effectiveness

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, June 2018
Subject(s):
Biohazard Release -- prevention & control
Toxins, Biological
Guideline Adherence
Laboratories
Safety
Humans
United States
United States. Department of Health and Human Services.
Centers for Disease Control and Prevention (U.S.)

41. Opioid use in Medicare Part D remains concerning

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, June 2018
Subject(s):
Analgesics, Opioid -- therapeutic use
Medicare Part D
Opioid-Related Disorders -- epidemiology
Prescription Drug Misuse
Analgesics, Opioid -- economics
Fentanyl -- adverse effects
Prescription Drug Diversion
Humans
United States
United States. Department of Health and Human Services.

42. CMS did not detect some inappropriate claims for durable medical equipment in nursing facilities

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, June 2018
Subject(s):
Durable Medical Equipment -- economics
Insurance, Health, Reimbursement
Medicare -- economics
Skilled Nursing Facilities
Home Care Services -- economics
Insurance Claim Review
Insurance Coverage
Medicaid -- economics
Nursing Homes
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

43. Opioids in Ohio Medicaid: review of extreme use and prescribing

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, July 2018
Subject(s):
Analgesics, Opioid -- therapeutic use
Inappropriate Prescribing
Medicaid
Opioid-Related Disorders -- epidemiology
Opioid-Related Disorders -- prevention & control
Prescription Drug Misuse
Analgesics, Opioid -- administration & dosage
Humans
Ohio
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

46. Medicare Part B drug payments: impact of price substitutions based on 2016 average sales prices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2018
Subject(s):
Drug Costs
Insurance, Health, Reimbursement
Medicare Part B -- economics
Cost Savings
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

47. Questionable billing for compounded topical drugs in Medicare Part D

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, August 2018
Subject(s):
Dermatologic Agents -- economics
Dermatologic Agents -- therapeutic use
Drug Compounding -- economics
Drug Utilization -- trends
Fraud
Insurance, Health, Reimbursement
Medicare Part D -- economics
Skin Cream -- economics
Administration, Topical
Dermatologic Agents -- adverse effects
Drug Compounding -- standards
Forecasting
Health Expenditures -- trends
Insurance Coverage
Skin Cream -- adverse effects
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

48. FDA should further integrate its review of cybersecurity into the premarket review process for medical devices

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2018
Subject(s):
Computer Security
Device Approval -- standards
Equipment and Supplies -- standards
Equipment Safety -- standards
Computer Communication Networks -- standards
Guidelines as Topic
Software -- standards
Humans
United States
United States. Department of Health and Human Services.
United States. Food and Drug Administration.

49. Treatment planning and medication monitoring were lacking for children in foster care receiving psychotropic medication

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2018
Subject(s):
Antipsychotic Agents -- therapeutic use
Foster Home Care
Medication Therapy Management
Patient Care Planning
Child
Child Health Services -- standards
Inappropriate Prescribing
Mental Disorders -- drug therapy
Practice Guidelines as Topic
State Government
Humans
United States
United States. Department of Health and Human Services.

50. Medicare payments for clinical diagnostic laboratory tests in 2017: year 4 of baseline data

Publication:
[Washington, D.C.] : U.S. Department of Health and Human Services, Office of Inspector General, September 2018
Subject(s):
Clinical Laboratory Techniques -- economics
Insurance, Health, Reimbursement
Medicare Part B -- economics
Prospective Payment System
Humans
United States
United States. Department of Health and Human Services.
Centers for Medicare & Medicaid Services (U.S.)

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