Healthcare

IDFPR February 2025 Enforcement Actions

The Illinois Department of Financial and Professional Regulation (IDFPR) announced enforcement actions taken in February 2025 against 30 entities. Actions include license suspensions, consent orders for violations of various acts, and settlements for late renewal payments.

OIG Audit: Medicaid Agencies Made $207M in Unallowable Payments for Deceased Enrollees

The HHS OIG has released an audit report finding that Medicaid agencies made an estimated $207.5 million in unallowable capitation payments to managed care organizations on behalf of deceased enrollees between July 2021 and June 2022. The report recommends CMS provide agencies with data to recover payments and explore OBBB Act implementation.

Maine Medicaid Autism Services Improper Payments

The HHS OIG has issued a report finding that Maine made at least $45.6 million in improper fee-for-service Medicaid payments for autism services provided to children. The audit identified that all sampled claims were improper or potentially improper, leading to recommendations for refunds and improved provider guidance.

HHS OIG: ACF Can Improve Homeless Youth Services Compliance

The HHS Office of Inspector General (OIG) issued a report finding that the Administration for Children and Families (ACF) can improve services to homeless youth by strengthening grant recipients' compliance with Transitional Living Program (TLP) requirements. The audit found significant documentation gaps in service provision for a large percentage of youth served by TLP grants.

HHS OIG: Hospital Cybersecurity Controls Need Improvement

The HHS Office of Inspector General (OIG) issued a report finding that a large southeastern hospital needs to improve its cybersecurity controls, particularly for web applications. The OIG made four recommendations to enhance defenses against cyberattacks, which the hospital has concurred with.

Philadelphia K-12 Schools COVID-19 Testing Program Audit

The HHS Office of Inspector General found that Philadelphia did not consistently monitor its COVID-19 screening testing program for K-12 schools, leading to $257,620 in unallowable costs and overpayments. The OIG recommended Philadelphia update its procedures for oversight and compliance.