The Maryland Department of Health is headquartered at 201 W. Preston St. in Baltimore. (Zackary Lang / Spotlight on Maryland)
MARYLAND (WBFF) —Maryland’s Office of Inspector General for Health (OIGH) has identified more than $42 million in improper or unrecovered payments over the last four years, according to a new evaluation that also urged the agency to make more of its work available to the public
The findings came from the Office of Legislative Audits, which issued its first evaluation of the inspector general’s office since it became independent from the Maryland Department of Health in 2022. The audit reviewed the inspector general’s work detecting improper Medicaid payments and monitoring spending at local health departments
“According to agency records, OIGH conducted 1,369 investigations and 53 audits during fiscal years 2023 through 2025 that collectively identified $41.9 million for recovery,” the Office of Legislative Audits said in its September report. “Our review disclosed that while OIGH reported these results to the applicable entities and MDH (Maryland Department of Health), it did not make the reports publicly available.”
The audit said the inspector general made its reports available to audited agencies and health departments, but only provided them to the public upon request. The only recommendation from the Office of Legislative Audits was that the inspector general should “consider publicly disclosing the results of its audits and investigations to the extent possible.”
The inspector general’s office has already begun moving in that direction. It created a public-facing website in August and posted the first 20 reports earlier this month
Those 20 reports outline about $4.3 million owed to the state by health care providers and another $1.7 million owed by local health departments. The local health department discrepancies were tied to errors in documentation, missing equipment and other fiscal issues. The amounts ranged from $63 owed by the Frederick County Health Department to more than $1.5 million owed by the Dorchester County Health Department to the Maryland Department of Health.
The posted reports also found $4.3 million owed by 13 health care providers — including behavioral health and developmental disability services — due to issues such as inadequate documentation of expenditures or not returning duplicate payments
Auditors noted that some information may still need to be withheld because of sensitive health and medical information or potential law enforcement involvement. The inspector general’s office raised those concerns in its response to state auditors
“OIGH reviews of providers suspected of submitting improper claims for reimbursement to the Medicaid program or persons allegedly improperly receiving benefits are not appropriate for general publication,” the agency said. “All these investigations involve protected personal information and/or protected health information that is required to be kept confidential by multiple federal and State laws.
“Some of these investigations are referred to law enforcement agencies to be considered for criminal or civil prosecution,” the agency said. “Publication of these investigations could jeopardize a confidential law enforcement investigation or run afoul of rules regarding pre-trial publicity of pending cases.”
It was not clear how much of the money identified since fiscal 2023 has been recovered. After the inspector general identifies potentially mishandled funds, it alerts the Maryland Department of Health, which is responsible for what happens next
“The Department of Health, not OIGH, handles recoveries of funds and has historically forgiven portions of the overpayments identified by OIGH,” the inspector general’s office said in a recent report
The audit comes as state lawmakers have put new emphasis on reducing repeat audit findings by improving operations within state agencies and ensuring taxpayer dollars are spent appropriately
The inspector general’s office may also face challenges in expanding transparency and enforcement because of staffing shortages. The agency reported nine vacancies among 47 budgeted positions for most of fiscal 2025 — a 19% vacancy rate — according to its annual report. The vacancies were attributed in part to a hiring freeze ordered by the Moore administration and a mandated midyear budget cut.
Staffing challenges continued into fiscal 2026 and are expected to affect the next fiscal year. With a $6 million budget, the inspector general said filling positions would be a worthwhile investment
“OIGH is a revenue-generating agency,” the agency said in its most recent annual report. “Persistent vacancies and position cuts will directly and adversely impact the number of investigations the OIGH can complete and result in lower recoveries in future years
“But for a forty-seven-person agency, the impact of a nineteen percent vacancy rate and eight and half percent reduction in force is a substantial hurdle to fulfilling its mission and will result in lower recoveries in future years,” the audit said
OIGH26PDF preview
You can read the audit report above
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