HHS OIG Work Plan

TANF Cash Assistance Program Oversight Audit Series Announced

HHS OIG announced a new audit series (SRS-A-26-017) to examine state oversight of the Temporary Assistance for Needy Families (TANF) program, which distributes $16.6 billion annually in federal block grant funds to states. The audits will focus on whether states provided adequate oversight of TANF cash assistance programs, including the use of electronic benefit transfer (EBT) cards. One project (OAS-26-09-021) has been announced with an estimated completion in FY2028.

NIH Recipients' Oversight of Domestic Subrecipients

HHS OIG announced a new evaluation (OEI-04-26-00170) to assess NIH prime recipients' adherence to requirements for oversight of domestic subrecipients under the NIH Grants Policy Statement and OMB Uniform Guidance. The evaluation aims to reduce fraud, waste, and abuse in domestic NIH subawards, with an estimated completion date of FY2028.

FDA Oversight of Compounded GLP-1 Drugs, Active

HHS OIG announced an active study to assess FDA's oversight of compounded glucagon-like peptide-1 receptor agonist (GLP-1) drugs. The study will examine FDA's inspection of compounding facilities and use of available data to identify and address potential risks to patients. GLP-1 drugs were on FDA's drug shortage list from 2022 to 2025, during which compounding facilities were permitted to produce copies. The study is estimated for completion in fiscal year 2028.

Medicare Advantage Risk-Adjustment Data - Documentation Review

The HHS OIG announced a series of projects to review documentation supporting diagnosis codes submitted by Medicare Advantage organizations to CMS. CMS estimates 9.5% of payments to MA organizations are improper due to unsupported diagnoses.

Hospital Billing Requirements Review for Overpayment Risk

The Centers for Medicare and Medicaid Services (CMS) announced a review series focused on hospital billing requirements to identify overpayment risks. A completed project for Sarasota Memorial Hospital identified at least $12.1 million in Medicare overpayments due to non-compliance with billing requirements.

Kidney Transplant Patient Selection Criteria and Waitlist Outcomes Report

The HHS Office of Inspector General has completed a report on patient selection criteria for kidney transplants and waitlist outcomes. The report found that half of patients evaluated for a kidney transplant in 2023 were not added to the waitlist, with psychosocial criteria being a common reason for denial.

Medicaid Applied Behavior Analysis Audits for Children with Autism

The HHS Office of Inspector General announced a series of audits of Medicaid Applied Behavior Analysis (ABA) services for children with autism. These audits aim to determine if state Medicaid agencies' payments complied with federal and state requirements, following identification of questionable billing patterns.

HHS Agencies' Drug Control Funds Review Completed

The HHS Office of Inspector General has completed its mandatory review of HHS agencies' annual accounting of National Drug Control Program funds for fiscal year 2025. The review, which assessed compliance with ONDCP circular requirements, found no material modifications needed for the CDC and FDA reports.