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Centers for Medicare and Medicaid Services (CMS)

CMS Document Archive

2019

07-17-2019
New York Did Not Correctly Determine Medicaid Eligibility for Some Non-Newly Eligible Beneficiaries (A-02-16-01005)
07-09-2019
Kentucky Did Not Comply With Federal Waiver and State Requirements at 14 of 20 Adult Day Health Care Facilities Reviewed  (A-04-18-00123)
07-02-2019
New York's Claims for Medicaid Nursing Home Transition and Diversion Waiver Program Services Generally Complied With Federal and State Requirements but Had Reimbursement Errors That Resulted in a Minimal Amount of Overpayments (A-02-17-01005)
07-01-2019
New York Claimed Federal Reimbursement for Some Payments to Health Home Providers That Did Not Meet Medicaid Requirements (A-02-17-01004)
Medicare Part D Rebates for Prescriptions Filled at 340B Contract Pharmacies (A-03-16-00002)
06-27-2019
Recommendation Followup: Delaware Is Reporting Medicaid Overpayments In Compliance With Federal Requirements (A-03-17-00203)
06-18-2019
Illinois Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-18-00030)
06-13-2019
Medicare Could Have Saved Millions of Dollars in Payments for Three-Dimensional Conformal Radiation Therapy Planning Services (A-09-18-03026)
06-12-2019
CMS Could Use Medicare Data To Identify Instances of Potential Abuse or Neglect (A-01-17-00513)
Incidents of Potential Abuse and Neglect at Skilled Nursing Facilities Were Not Always Reported and Investigated (A-01-16-00509)
Medicare Payments to Providers for Polysomnography Services Did Not Always Meet Medicare Billing Requirements (A-04-17-07069)
06-11-2019
Alaska Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities (A-09-17-02006)
06-04-2019
Princeton Place Did Not Always Comply With Care Plans for Residents Who Were Diagnosed With Urinary Tract Infections (A-06-17-02002)
The Therapy Resource Utilization Groups at Epworth Villa Retirement Community's Skilled Nursing Facility Were Properly Supported (A-06-18-08002)
05-30-2019
New York May Not Have Complied With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-02-16-01022)
05-28-2019
Great Lakes Home Health Services, Inc., Billed for Home Health Services That Did Not Comply With Medicare Coverage and Payment Requirements (A-05-16-00057)
05-23-2019
St. Joseph's Hospital and Medical Center Submitted Some Inaccurate Wage Data (A-01-17-00510)
05-20-2019
Metropolitan Jewish Home Care, Inc., Billed for Home Health Services That Did Not Comply with Medicare Requirements (A-02-16-01001)
05-16-2019
Four States Did Not Comply With Federal Waiver and State Requirements in Overseeing Adult Day Care Centers and Foster Care Homes (A-05-19-00005)
05-13-2019
EHS Home Health Care Service, Inc., Billed for Home Health Services That Did Not Comply With Medicare Coverage and Payment Requirements (A-05-16-00055)
05-09-2019
New Jersey Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-02-16-01012)
05-08-2019
Massachusetts Did Not Ensure Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-01-17-00003)
Excella HomeCare Billed for Home Health Services That Did Not Comply With Medicare Coverage and Payment Requirements (A-01-16-00500)
05-07-2019
California Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries’ Deaths (A-04-18-06220)
04-30-2019
Some Diagnosis Codes That Essence Healthcare, Inc., Submitted to CMS Did Not Comply With Federal Requirements (A-07-17-01170)
04-29-2019
Medicaid Could Save Hundreds of Millions by Excluding Authorized Generic Drug Transactions to Secondary Manufacturers from Brand Name Drugs’ Average Manufacturer Price Calculations (A-06-18-04002)
04-26-2019
Trends in Deficiencies at Nursing Homes Show That Improvements Are Needed To Ensure the Health and Safety of Residents (A-09-18-02010)
04-05-2019
Indiana Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-17-00038)
03-27-2019
Factsheet: Texas' Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-06-18-04000)
03-25-2019
New Jersey Did Not Provide Adequate Oversight of Its Medicaid Delivery System Reform Incentive Payment Program (A-02-17-01007)
03-05-2019
Factsheet: West Virginia's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-03-18-03302)
Missouri Claimed Some Unallowable Medicaid Payments for Targeted Case Management Services (A-07-17-03219)
02-28-2019
Michigan Disbursed Only Part of Its Civil Money Penalty Collections, Limiting Resources To Protect or Improve Care for Nursing Facility Residents (A-05-17-00019)
02-25-2019
Factsheet: New Hampshire's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-01-18-01501)
02-14-2019
CMS Improperly Paid Millions of Dollars for Skilled Nursing Facility Services When the Medicare 3-Day Inpatient Hospital Stay Requirement Was Not Met (A-05-16-00043)
Factsheet: Nevada's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-09-18-01004)
02-12-2019
New Mexico Did Not Always Appropriately Refund the Federal Share of Recoveries from Managed Care Organizations (A-06-18-09001)
TrustSolutions, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals (A-07-18-00540)
02-08-2019
Factsheet: Utah's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-07-18-05115)
02-06-2019
Factsheet: Tennessee's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-04-18-00124)
02-07-2019
CMS Guidance to State Survey Agencies on Verifying Correction of Deficiencies Needs To Be Improved To Help Ensure the Health and Safety of Nursing Home Residents (A-09-18-02000)
02-06-2019
Medicare Paid Twice for Ambulance Services Subject to Skilled Nursing Facility Consolidated Billing Requirements (A-01-17-00506)
02-04-2019
Medicare Compliance Review of Community Hospital (A-05-17-00026)
01-31-2019
Factsheet: Nebraska's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-07-18-06080)
01-17-2019
Kelley Medical Equipment and Supply, LLC, Received Unallowable Medicare Payments for Orthotic Braces (A-09-17-03030)
01-15-2019
Although the Centers for Medicare & Medicaid Services Has Made Progress, It Did Not Always Resolve Audit Recommendations in Accordance With Federal Requirements (A-07-18-03228)
01-10-2019
Virginia Received Millions in Unallowable Bonus Payments (A-04-17-08060)
01-04-2019
Rhode Island Did Not Ensure Its Managed Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-01-17-00004)

2018

12-31-2018
A Queens Chiropractor Received Improper Medicare Payments for Chiropractic Services (A-02-15-01003)
Pacific Medical, Inc., Received Some Unallowable Medicare Payments for Orthotic Braces (A-09-17-03027)
12-28-2018
Dialysis Services Provided by Atlantis Health Care Group of Puerto Rico, Inc., Did Not Comply With Medicare Requirements Intended To Ensure the Quality of Care Provided to Medicare Beneficiaries (A-02-16-01009)
12-20-2018
First Coast Service Options, Inc., Paid Providers for Hyperbaric Oxygen Therapy Services That Did Not Comply With Medicare Requirements (A-04-16-06196)
12-19-2018
Midwood Ambulance & Oxygen Service, Inc., Billed for Nonemergency Ambulance Transport Services That Did Not Comply With Medicare Requirements (A-02-16-01021)
12-17-2018
Louisiana Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-06-16-02003)
12-13-2018
Wisconsin Did Not Report and Refund the Full Federal Share of Medicaid-Related Settlements and a Judgment (A-05-17-00041)
12-12-2018
Texas Claimed Community First Choice Fee-for-Service Expenditures Appropriately (A-06-17-08002)
12-11-2018
Factsheet: Washington State's Oversight of Opioid Prescribing and Monitoring of Opioid Use (A-09-18-02001)
California Made Medicaid Payments on Behalf of Non-Newly Eligible Beneficiaries Who Did Not Meet Federal and State Requirements (A-09-17-02002)
12-07-2018
The Centers for Medicare & Medicaid Services Had Not Recovered More Than a Billion Dollars in Medicaid Overpayments Identified by OIG Audits (A-05-17-00013)
12-06-2018
Payments Made by National Government Services, Inc., to Hospitals for Certain Advanced Radiation Therapy Services Did Not Fully Comply With Medicare Requirements (A-02-16-01007)
Vulnerabilities Exist in State Agencies' Use of Random Moment Sampling To Allocate Costs for Medicaid School-Based Administrative and Health Services Expenditures (A-07-18-04107)
11-30-2018
Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2017 (A-18-18-11300)
11-29-2018
Medicare Improperly Paid Suppliers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Beneficiaries During Inpatient Stays (A-09-17-03035)
11-27-2018
CMS's Enhanced Controls Did Not Always Prevent Terminated Drug Utilization in Medicare Part D (A-07-16-06068)
11-23-2018
New York May Have Improperly Claimed Medicaid Reimbursement for Certain Dental Services (A-02-16-01020)
Summary of Security Vulnerabilities Identified at Two Arizona Managed Care Organizations and Inconsistent Treatment of Medicaid Data Security at the State Agency and Managed Care Organizations (A-18-17-09302)
11-21-2018
Significant Vulnerabilities Exist in the Hospital Wage Index System for Medicare Payments (A-01-17-00500)
11-07-2018
National Government Services, Inc., Understated Its Plan A Medicare Segment Pension Assets (A-07-18-00541)
National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs (A-07-18-00543)
National Government Services, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs (A-07-18-00552)
11-08-2018
Payments Made by Novitas Solutions, Inc., to Hospitals for Certain Advanced Radiation Therapy Services Did Not Fully Comply With Medicare Requirements (A-02-16-01006)
Although Hospital Tax Programs in Seven States Complied With Hold-Harmless Requirements, the Tax Burden on Hospitals Was Significantly Mitigated (A-03-16-00202)
11-01-2018
CMS Did Not Always Ensure Hospitals Complied With Medicare Reimbursement Requirements for Graduate Medical Education (A-02-17-01017)
10-25-2018
New York Claimed Federal Reimbursement for Some Assertive Community Treatment Services That Did Not Meet Medicaid Requirements (A-02-17-01008)
10-24-2018
Professional Clinical Laboratory, Inc., Generally Did Not Comply With Medicare Requirements For Billing Phlebotomy Travel Allowances (A-06-16-02002)
10-18-2018
Medicare Compliance Review of Mobile Infirmary Medical Center (A-04-17-08057)
10-16-2018
United Government Services, LLC, Properly Updated the Medicare Segment Pension Assets as of January 1, 2015 (A-07-18-00538)
TrustSolutions, LLC, Properly Updated the Medicare Segment Pension Assets as of December 31, 2012 (A-07-18-00539)
National Government Services, Inc., Properly Updated the Plan B Medicare Segment Pension Assets as of January 1, 2015 (A-07-18-00542)
10-15-2018
Wisconsin Did not Comply With Federal Waiver and State Requirements at all 20 Adult Day Care Centers Reviewed (A-05-17-00030)
10-04-2018
Ohio Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries� Deaths 
09-27-2018
Wisconsin Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries� Deaths (A-05-17-00006)
Many Inpatient Rehabilitation Facility Stays Did Not Meet Medicare Coverage and Documentation Requirements (A-01-15-00500)
09-19-2018
Etheredge Chiropractic Received Unallowable Medicare Payments for Chiropractic Services (A-04-16-07064)
09-11-2018
First Coast Service Options, Inc., Overstated Medicare�s Share of the Medicare Segment Excess Pension Liabilities (A-07-18-00535)
09-06-2018
National Institute of Transplantation, an Independent Histocompatibility Laboratory, Did Not Fully Comply With Medicare�s Cost-Reporting Requirements (A-09-16-02010)
09-04-2018
CMS Enrollment System Needs To Enhance Resiliency (A-18-17-06501)
08-20-2018
Mississippi Did Not Comply With Federal Waiver and State Requirements at All 20 Adult Day Care Facilities Reviewed (A-04-17-00116)
08-17-2018
Liberty Medical, LLC, Received Unallowable Medicare Payments for Inhalation Drugs (A-09-17-03019)
06-25-2018
Virginia Did Not Claim Some Medicaid Administrative Costs for Its Medallion 3.0 Waiver Program In Accordance With Federal Requirements (A-03-17-00200)
08-15-2018
Medicare Improperly Paid Hospitals Millions of Dollars for Intensity-Modulated Radiation Therapy Planning Services (A-09-16-02033)
Medicare Made Improper and Potentially Improper Payments for Emergency Ambulance Transports to Destinations Other Than Hospitals or Skilled Nursing Facilities (A-09-17-03017)
08-08-2018
California Claimed Millions of Dollars in Unallowable Federal Medicaid Reimbursement for Specialty Mental Health Services (A-09-15-02040)
California Created a Medicaid Program Vulnerability by Reporting Placeholders That Did Not Represent Actual Expenditures Supported by Documentation (A-09-15-02027)
08-09-2018
Maryland Did Not Adequately Secure Its Medicaid Data and Information Systems (A-18-16-30520)
Alaska Received Millions in Unallowable Bonus Payments (A-04-17-08059)
08-08-2018
CMS Did Not Always Accurately Authorize Financial Assistance Payments to Qualified Health Plan Issuers in Accordance With Federal Requirements During the 2014 Benefit Year (A-02-15-02013)
07-31-2018
Medicare Compliance Review of WakeMed Raleigh Campus (A-04-17-04057)
07-24-2018
Illinois Did Not Comply With Federal Waiver and State Requirements at 18 of 20 Adult Day Service Centers Reviewed (A-05-17-00028)
Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part A Administrative Costs for Fiscal Year 2013 (A-05-16-00052)
Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part B Administrative Costs for Fiscal Year 2013 (A-05-16-00053)
07-16-2018
First Coast Service Options, Inc., Did Not Claim Some Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals (A-07-18-00536)
First Coast Service Options, Inc., Generally Claimed Allowable Pension Costs Through Its Incurred Cost Proposals (A-07-18-00534)
07-11-2018
Medicare Improperly Paid Providers for Nonemergency Ambulance Transports to Destinations Not Covered by Medicare (A-09-17-03018)
07-09-2018
The Colorado Health Insurance Marketplace�s Financial Management System Did Not Always Comply With Federal Requirements (A-07-17-02808)
07-05-2018
Medicare Improperly Paid Providers for Items and Services Ordered by Chiropractors (A-09-17-03002)
06-25-2018
Virginia Did Not Claim Some Medicaid Administrative Costs for Its Medallion 3.0 Waiver Program In Accordance With Federal Requirements (A-03-17-00200)
06-14-2018
Michigan Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Brokerage Program (A-05-16-00021)
06-07-2018
Most Medicare Claims for Replacement Positive Airway Pressure Device Supplies Did Not Comply With Medicare Requirements (A-04-17-04056)
06-05-2018
Companion Data Services, LLC, Did Not Claim Some Allowable Pension Costs Through Its Incurred Cost Proposals (A-07-17-00528)
06-04-2018
New York Claimed Federal Reimbursement for Consumer-Directed Personal Assistance Services That Did Not Meet Medicaid Requirements (A-02-16-01026)
06-01-2018
University of Wisconsin Hospitals and Clinics Authority Incorrectly Billed Medicare Inpatient Claims With Severe Malnutrition (A-03-17-00005)
05-30-2018
Nebraska Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-07-17-03224)
Texas Made Increased Payments for Services Rendered by Eligible Primary Care Providers Under Federal Requirements (A-06-17-09003)
Minnesota Did Not Comply With Federal Waiver and State Requirements for All 20 Adult Day Care Centers Reviewed (A-05-17-00009)
05-29-2018
Nevada Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-09-15-02039)
05-22-2018
CMS Did Not Always Provide Accurate Medicaid Unit Rebate Offset Amounts to State Medicaid Agencies (A-07-17-06074)
05-14-2018
Iowa Complied With Most Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-07-17-03221)
Missouri Did Not Comply With Federal and State Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions (A-07-16-03216)
05-10-2018
Wisconsin Physicians Service Insurance Corporation Understated Medicare Administrative Contract Allowable Pension Costs (A-07-17-00530)
Wisconsin Physicians Service Insurance Corporation Understated Medicare�s Share of the Medicare Segment Excess Pension Assets (A-07-17-00529)
04-30-2018
Cahaba Safeguard Administrators, LLC, Understated Medicare Administrative Contract Allowable Pension Costs (A-07-17-00526)
Cahaba Government Benefits Administrators, LLC, Understated Medicare Administrative Contract Allowable Pension Costs (A-07-17-00525)
Cahaba Government Benefits Administrators, LLC, Generally Claimed Allowable Medicare Pension Costs (A-07-17-00524)
04-27-18
Florida Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid  (A-04-17-08052)
04-25-2018
Cahaba Government Benefits Administrators, LLC, Overstated Its Medicare Segment Pension Assets (A-07-17-00522)
04-24-2018
Most of New York�s Claims for Federal Reimbursement for Monthly Personal Emergency Response Service Charges Did Not Comply With Medicaid Requirements (A-02-15-01019)
Cahaba Safeguard Administrators, LLC, Understated Its Medicare Segment Pension Assets (A-07-17-00523)
First Coast Service Options, Inc.�s, Postretirement Benefit Costs Were Reasonable and Allowable (A-07-17-00501)
04-18-2018
Colorado Did Not Always Comply With Federal Requirements When Expending Federal Establishment Grant Funds Allocated for Its Shared Eligibility System Costs (A-07-16-02804)
04-12-2018
CMS's Policies and Procedures Were Generally Effective in Ensuring That Prescription Drug Coverage Capitation Payments Were Not Made After the Beneficiaries' Dates of Death (A-07-16-05088)
04-05-2018
CMS Paid Practitioners for Telehealth Services That Did Not Meet Medicare Requirements (A-05-16-00058)
04-04-2018
Colorado Claimed Some Unallowable Medicaid Payments for Targeted Case Management Services (A-07-16-03215)
Texas Did Not Make Increased Primary Care Provider Payments and Claim Reimbursement in Accordance With Federal Requirements (A-06-15-00045)
03-21-2018
New Jersey Claimed Federal Medicaid Reimbursement for Children's Partial Hospitalization Services That Did Not Meet Federal and State Requirements (A-02-16-01008)
03-20-2018
Idaho Received Millions in Unallowable Bonus Payments (A-04-17-08056)
03-16-2018
New York Did Not Comply With Federal Grant Requirements for Claiming Marketplace Contract Costs to Medicaid and the Children's Health Insurance Program  (A-02-15-01014)
03-14-2018
Many Medicare Claims for Outpatient Physical Therapy Services Did Not Comply With Medicare Requirements (A-05-14-00041)
03-08-2018
Hospitals Did Not Comply With Medicare Requirements for Reporting Certain Cardiac Device Credits (A-05-16-00059)
03-06-2018>
Oklahoma Did Not Have Procedures to Identify Provider-Preventable Conditions on Some Inpatient Hospital Claims (A-06-16-08004)
02-20-2018
California Made Medicaid Payments on Behalf of Newly Eligible Beneficiaries Who Did Not Meet Federal and State Requirements (A-09-16-02023)
02-16-2018
Arizona Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02031)
02-14-2018
Medicare Improperly Paid Providers for Specimen Validity Tests Billed in Combination With Urine Drug Tests  (A-09-16-02034)
Wisconsin Physicians Service Paid Providers for Hyperbaric Oxygen Therapy Services That Did Not Comply With Medicare Requirements (A-01-15-00515)
02-13-2018
Medicare Compliance Review of Memorial University Medical Center (A-04-17-08055)
02-12-2018
Medicare Needs Better Controls To Prevent Fraud, Waste, and Abuse Related to Chiropractic Services (A-09-16-02042)
Arkansas Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-06-16-00018)
02-09-2018
Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2016 (A-18-17-11300)
01-31-2018
Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Pension Costs Through Its Incurred Cost Proposals (A-07-17-00506)
01-30-2018
CGS Administrators, LLC, Did Not Claim Some Allowable Pension Costs Through Its Incurred Cost Proposals (A-07-17-00513)
01-23-2018
Medicare Compliance Review of the University of Michigan Health System (A-05-16-00064)
01-11-2018
Medicare Compliance Review of Carolinas Medical Center (A-04-16-04049)
01-05-2018
Wisconsin Physicians Service Insurance Corporation Did Not Claim Some Allowable Medicare Pension Costs (A-07-17-00519)
Wisconsin Physicians Service Insurance Corporation Understated Its Allocable Pension Costs (A-07-17-00520)
New York Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries (A-02-15-01015)
01-04-2018
North Carolina Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-04-17-02500)
Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Employees' Pension Plan (A-07-17-00516)
Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Managerial Retirement Program for Selected Locations (A-07-17-00517)
Wisconsin Physicians Service Insurance Corporation Understated Its Medicare Segment Pension Assets for Its Managerial Pension Plan (A-07-17-00518)