NYSDA Publications

HHS OIG Issues Report on HHS Payment Integrity Compliance

May 20, 2024

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued a report on HHS compliance with payment integrity requirements for various federal programs.

Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for the Fiscal Year 2023 (A-17-24-52000)

Ernst & Young (EY), LLP, determined that HHS met many requirements but did not fully comply with Payment Integrity Information Act of 2019 (PIIA).  Among the items required for compliance with PIIA that HHS complied with, EY determined that HHS: 1) published the Agency Financial Report for Fiscal Year 2023; and 2) conducted risk assessments for 56 programs not susceptible to improper payments and determined the programs were not at risk for improper payments.  While HHS conducted these program specific risk assessments, they did not risk assess each program with annual outlays greater than $10 million at least once in every three years.  Also, HHS had not fully implemented recovery audit activities for the identified improper payments for the Medicare Advantage (Part C) program in Fiscal Year 2023, as required by PIIA.

Read the Full Report