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Tennessee Claimed Federal Medicaid Reimbursement for Millions of Dollars in Targeted Case Management Services That Did Not Comply With Federal and State Requirements

In 2024, ORR’s National Call Center Connected Children with Supports and Services

New York Made Unallowable Managed Care Capitation Payments on Behalf of Incarcerated Medicaid Enrollees

Medicaid Managed Care: CMS’s Accuracy Check Process For State-Submitted Medical Loss Ratio Data Has Limitations

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2024 Average Sales Prices

Connecticut Could Better Ensure That the Department of Developmental Services and Providers Fully Comply With Federal Waiver and State Health and Safety Requirements for Individualized Home Support Services

North Carolina Medicaid Fraud Control Unit: 2025 Onsite Inspection

Methodist Hospital Received at Least $12.4 Million in Medicare Overpayments

Medicare Hospital Provider Compliance Audit: McLeod Regional Medical Center

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HumanaChoice (Contract H5216) Submitted to CMS

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UnitedHealthcare of Wisconsin, Inc. (Contract H5253) Submitted to CMS

The IHS Navajo Area Office’s Internal Controls for Awarding, Monitoring, and Reporting Sanitation Facilities Construction Projects Could Be Improved

Medicare Advantage Organizations and CMS Can Do More To Prevent Durable Medical Equipment Fraud in Medicare Advantage

Alabama Medicaid Fraud Control Unit: 2025 Inspection

OIG Final Data Brief: Snapshot of Indian Health Service Sanitation Facilities Construction Projects Funded Under the Infrastructure Investment and Jobs Act

South Carolina Did Not Ensure That Selected Medicaid Managed Care Organizations Complied With Mental Health and Substance Use Disorder Parity Requirements Related to Prior Authorization

California Did Not Report and Return All Medicaid Overpayments for the State’s Medicaid Fraud Control Unit Cases

CMS Could Improve Oversight of States' Use of Contract Surveyors for Nursing Home Surveys

NIH Awarded Other Transaction Agreements for the Autism Data Science Initiative in Accordance With Federal Requirements

Conflicting CMS Guidance and Federal Statutory Requirements Cost Medicare $380 Million Over a 6-Year Period for Organs Not Transplanted Into Medicare Enrollees

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