Centers for Medicare and Medicaid Services (CMS)
2023
- 11-27-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That SelectCare of Texas, Inc. (Contract H4506), Submitted to CMS A-06-19-05002
- 11-24-2023
- Multiple States Made Medicaid Capitation Payments to Managed Care Organizations After Enrollees' Deaths A-04-21-09005
- 11-16-2023
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2022 A-18-23-11300
- 11-08-2023
- Pennsylvania Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-03-22-00206
- 11-07-2023
- CMS Can Do More To Leverage Medicare Claims Data To Identify Unreported Incidents of Potential Abuse or Neglect A-01-22-00501
- 11-01-2023
- Noridian Healthcare Solutions Reopened and Corrected Cost Report Final Settlements To Collect $11 Million in Net Overpayments That Had Been Made to Medicare Providers A-06-22-05000
- 10-26-2023
- Medicare Advantage Compliance Audit of Diagnosis Codes That CarePlus Health Plans, Inc. (Contract H1019) Submitted to CMS A-04-19-07082
- 10-20-2023
- States Face Ongoing Challenges in Meeting Third-Party Liability Requirements for Ensuring That Medicaid Functions as the Payer of Last Resort A-05-21-00013
- 10-18-2023
- South Dakota MMIS and E&E System Security Controls Were Partially Effective and Improvements Are Needed A-18-21-09004
- Mississippi Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-21-06103
- 10-06-2023
- Medicare Could Save Millions if It Implements an Expanded Hospital Transfer Payment Policy for Discharges to Postacute Care A-01-21-00504
- 10-02-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Aetna, Inc. (Contract H5521) Submitted to CMS A-01-18-00504
- 09-29-2023
- New Jersey Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-02-22-01004
- 09-25-2023
- Home Health Agencies Rarely Furnished Services Via Telehealth Early in the COVID-19 Public Health Emergency A-05-21-00026
- 09-22-2023
- Medicare Advantage Compliance Audit of Diagnosis Codes That Health Net of California, Inc. (Contract H0562) Submitted to CMS A-09-18-03007
- Four States Reviewed Received Increased Medicaid COVID-19 Funding Even Though They Terminated Some Enrollees' Coverage for Unallowable or Potentially Unallowable Reasons A-06-21-09002
- 09-21-2023
- Alabama Did Not Always Invoice Rebates to Manufacturers for Pharmacy and Physician-Administered Drugs A-04-21-08090
- 09-18-2023
- New York Did Not Ensure That a Managed Care Organization Complied With Requirements for Denying Prior Authorization Requests A-02-21-01016
- 09-13-2023
- Amerigroup Iowa's Prior Authorization and Appeal Processes Were Effective, but Improvements Can Be Made A-07-22-07007
- 09-12-2023
- Novitas Solutions, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals A-07-23-00633
- Kentucky Did Not Always Invoice Manufacturers for Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-04-22-07102
- 09-11-2023
- Texas Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State A-05-22-00018
- Puerto Rico Claimed Over $7 Million in Federal Reimbursement for Medicaid Capitation Payments Made on Behalf of Enrollees Who Were or May Have Been Deceased A-02-21-01005
- 09-08-2023
- Puerto Rico Claimed More Than $500 Thousand in Unallowable Medicaid Managed Care Payments for Enrollees Assigned More Than One Identification Number A-02-21-01004
- Medicare Improperly Paid Acute-Care Hospitals for Inpatient Claims Subject to the Post-Acute-Care Transfer Policy Over a 4-Year Period, but CMS's System Edits Were Effective in Reducing Improper Payments by the End of the Period A-09-23-03016
- 09-07-2023
- Georgia Could Better Ensure That Nursing Homes Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control A-04-22-08093
- 08-31-2023
- Florida Did Not Refund $106 Million Federal Share of Medicaid Managed Care Rebates It Received for Calendar Years 2015 Through 2020 A-04-22-04089
- 08-17-2023
- Medicare Made $17.8 Million in Potentially Improper Payments for Opioid-Use-Disorder Treatment Services Furnished by Opioid Treatment Programs A-09-22-03005
- 08-09-2023
- Medicare Paid Independent Organ Procurement Organizations Over Half a Million Dollars for Professional and Public Education Overhead Costs That Did Not Meet Medicare Requirements A-09-21-03020
- Office of Inspector General's Partnership With the Commonwealth of Massachusetts Office of the State Auditor: Office of Medicaid (MassHealth)-Review of Capitation Payments A-01-22-00002
- States With Separate Children's Health Insurance Programs Could Have Collected an Estimated $641 Million Annually If States Were Required To Obtain Rebates Through the Medicaid Drug Rebate Program A-07-22-06106
- 08-08-2023
- Texas Inappropriately Claimed Nearly $1.8 Million in Federal Medicaid Funds for Private Medicaid Management Information System Contractor Costs A-06-19-09003
- 08-03-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Presbyterian Health Plan, Inc. (Contract H3204) Submitted to CMS A-07-20-01197
- 08-02-2023
- First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs A-07-23-00630
- First Coast Service Options, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals A-07-23-00632
- First Coast Service Options, Inc., Overstated Its Medicare Segment Postretirement Benefit Assets as of January 1, 2019 A-07-23-00629
- First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Supplemental Executive Retirement Plan Costs A-07-22-00626
- 08-01-2023
- Telehealth During 2020 Helped Ensure End-Stage Renal Disease Patients Received Care, But Limited Information Related to Telehealth Was Documented A-05-22-00015
- 07-31-2023
- New York Improved Its Monitoring of Medicaid Community Rehabilitation Services But Still Claimed Improper Federal Medicaid Reimbursement Totaling $20 Million A-02-22-01011
- Medicare Paid $30 Million for Accumulated Repair Costs That Exceeded the Federally Recommended Cost Limit for Wheelchairs During Their 5-Year Reasonable Useful Lifetime A-09-22-03003
- 07-19-2023
- Virginia Made Capitation Payments to Medicaid Managed Care Organizations After Enrollees' Deaths A-03-22-00203
- 07-10-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Excellus Health Plan, Inc. (Contract H3351) Submitted to CMS A-07-20-01202
- 06-27-2023
- Noridian Healthcare Solutions, LLC, Made $8.8 Million in Improper Monthly Capitation Payments to Physicians and Qualified Nonphysician Practitioners in Jurisdiction E for Certain Services Related to End-Stage Renal Disease A-09-21-03016
- 06-21-2023
- CMS's Oversight of Medicare Payments for the Highest Paid Molecular Pathology Genetic Test Was Not Adequate To Reduce the Risk of up to $888 Million in Improper Payments A-09-22-03010
- 05-31-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Keystone Health Plan East, Inc. (Contract H3952) Submitted to CMS A-03-20-00001
- 05-30-2023
- Medicare Paid Millions More for Physician Services at Higher Nonfacility Rates Rather Than at Lower Facility Rates While Enrollees Were Inpatients of Facilities A-04-21-04084
- 05-25-2023
- Maryland MMIS and E&E System Security Controls Were Partially Effective and Improvements Are Needed A-18-21-09003
- 05-24-2023
- The Centers for Medicare & Medicaid Services Should Improve Preventative and Detective Controls To More Effectively Mitigate the Risk of Compromise A-18-20-08001
- 05-17-2023
- Montana Generally Complied With Requirements for Telehealth Services During the COVID-19 Pandemic A-07-21-03250
- 05-16-2023
- Massachusetts MMIS and E&E System Security Controls Were Generally Effective, but Some Improvements Are Needed A-18-20-08003
- 05-02-2023
- Medicare Improperly Paid Providers for Some Psychotherapy Services, Including Those Provided via Telehealth, During the First Year of the COVID-19 Public Health Emergency A-09-21-03021
- 04-24-2023
- Medicare Could Have Saved Up To $128 Million Over 5 Years if CMS Had Implemented Controls To Address Duplicate Payments for Services Provided to Individuals With Medicare and Veterans Health Administration Benefits A-09-22-03004
- 04-10-2023
- CMS Did Not Accurately Report on Care Compare One or More Deficiencies Related to Health, Fire Safety, and Emergency Preparedness for an Estimated Two-Thirds of Nursing Homes A-09-20-02007
- 04-04-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HumanaChoice (Contract H6609) Submitted to CMS A-05-19-00013
- 03-28-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cigna-HealthSpring Life & Health Insurance Company, Inc. (Contract H4513) Submitted to CMS A-07-19-01192
- 03-24-2023
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That MCS Advantage, Inc. (Contract H5577) Submitted to CMS A-02-20-01008
- 03-22-2023
- Medicare Improperly Paid Physicians an Estimated $30 Million for Spinal Facet-Joint Interventions A-09-22-03006
- 03-21-2023
- Missouri's Oversight of Certified Individualized Supported Living Provider Health and Safety Could Be Improved in Some Areas A-07-21-03247
- 03-16-2023
- The District of Columbia Has Taken Significant Steps To Ensure Accountability Over Amounts Managed Care Organizations Paid to Pharmacy Benefit Managers A-03-20-00200
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Geisinger Health Plan (Contract H3954) Submitted to CMS A-09-21-03011
- 03-14-2023
- Georgia Did Not Comply With Federal Waiver and State Requirements at All 20 Adult Day Health Care Facilities Reviewed A-04-22-00134
- 03-13-2023
- Georgia Did Not Always Invoice Rebates to Manufacturers for Pharmacy and Physician-Administered Drugs A-04-21-08089
- 03-10-2023
- Medicare Improperly Paid Physicians for Epidural Steroid Injection Sessions A-07-21-00618
- 03-09-2023
- Michigan MMIS and E&E Systems Security Controls Were Generally Effective, but Some Improvements Are Needed A-18-20-08004
- 03-08-2023
- Texas Could Not Support the Permissibility of the Funds Used as the State Share of the Medicaid Delivery System Reform Incentive Payment Program A-06-17-09004
- 03-03-2023
- Florida Did Not Invoice Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-04-21-07098
- 02-28-2023
- Medicare Part D Plan Sponsors and CMS Did Not Ensure That Transmucosal Immediate-Release Fentanyl Drugs Were Dispensed Only to Beneficiaries Who Had a Cancer Diagnosis A-09-20-03033
- 02-27-2023
- Medicare Could Have Saved up to $216 Million Over 5 Years if Program Safeguards Had Prevented At-Risk Payments for Definitive Drug Testing Services A-09-21-03006
- 02-23-2023
- Missouri Claimed Federal Medicaid Reimbursement for Tens of Millions in Consumer-Directed Personal Care Assistance Services That Did Not Comply With Federal and State Requirements A-07-20-03243
- 02-16-2023
- Florida Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State A-05-21-00028
- 02-07-2023
- North Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-21-07002
- 01-05-2023
- National Government Services, Inc., Overstated Its Plan B Medicare Segment Pension Assets and Overstated Medicare's Share of the Medicare Segment Excess Pension Assets as of December 31, 2018 A-07-22-00621
- National Government Services, Inc., Understated Its Plan A Medicare Segment Pension Assets and Overstated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of December 31, 2018 A-07-22-00620
- 01-06-2023
- National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-22-00623
- National Government Services, Inc., Overstated Its United Government Services, LLC, Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of December 31, 2018 A-07-22-00622
2022
- 12-22-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cigna-HealthSpring of Tennessee, Inc. (Contract H4454) Submitted to CMS A-07-19-01193
- 12-21-2022
- Illinois Generally Complied With Requirements for Claiming Medicaid Reimbursement for Telehealth Payments During COVID-19 A-05-21-00035
- National Government Services, Inc., Claimed Some Unallowable Medicare Postretirement Benefit Plan Costs Through Its Incurred Cost Proposals A-07-22-00624
- National Government Services, Inc., Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals A-07-22-00625
- National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plan Costs Through Its Incurred Cost Proposals A-07-22-00628
- 12-20-2022
- Keystone First Should Improve Its Procedures for Reviewing Service Requests That Require Prior Authorization A-03-20-00201
- Mandated Analysis of Home Health Service Utilization From January 2016 Through March 2022 A-05-20-00031
- 12-15-2022
- Providers Did Not Always Comply With Federal Requirements When Claiming Medicare Bad Debts A-07-20-02825
- 12-08-2022
- The Centers for Medicare & Medicaid Services' Review Contractor Did Not Document Medicaid Managed Care Payment Review Determinations Made Under the Payment Error Rate Measurement Program A-04-21-09003
- 11-22-2022
- Medicare Improperly Paid Physicians for Co-Surgery and Assistant-at-Surgery Services That Were Billed Without the Appropriate Payment Modifiers A-01-20-00503
- Medicare Providers Did Not Always Comply With Federal Requirements When Billing for Advance Care Planning A-06-20-04008
- 11-18-2022
- Puerto Rico MMIS and E&E Systems Security Controls Were Generally Effective, but Some Improvements Are Needed A-18-20-08005
- 11-17-2022
- National Government Services, Inc., Accurately Calculated Hospice Cap Amounts but Did Not Collect All Cap Overpayments A-06-21-08004
- The Centers for Medicare & Medicaid Services' Review Contractors Generally Conducted Medicaid Fee-for-Service Claim Reviews for Selected States Under the Payment Error Rate Measurement Program in Accordance with Federal and State Requirements A-04-21-00132
- 11-16-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That BCBS of Rhode Island (Contract H4152) Submitted to CMS A-01-20-00500
- 11-10-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That California Physicians' Service, Inc. (Contract H0504) Submitted to CMS A-09-19-03001
- 11-09-2022
- The Number of Beneficiaries Who Received Medicare Part B Clinical Laboratory Tests Decreased During the First 10 Months of the COVID-19 Pandemic A-09-21-03004
- Iowa Implemented Most of Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Major Incidents A-07-21-06105
- 10-27-2022
- Mississippi Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-21-06101
- 10-26-2022
- CMS Can Use OIG Audit Reports To Improve Its Oversight of Hospital Compliance A-04-21-08084
- 10-25-2022
- California Made Almost $16 Million in Unallowable Capitation Payments for Beneficiaries With Multiple Client Index Numbers A-04-21-07097
- Colorado Did Not Report and Refund the Correct Federal Share of Medicaid-Related Overpayments for 70 Percent of the State's Medicaid Fraud Control Unit Cases A-07-21-02834
- CMS Generally Ensured That Medicare Part C and Part D Sponsors Did Not Pay Ineligible Providers for Services to Medicare Beneficiaries A-02-20-01027
- 10-24-2022
- Payments Made to Providers Under the COVID-19 Accelerated and Advance Payments Program Were Generally in Compliance with the CARES Act and Other Federal Requirements A-05-20-00053
- 09-30-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HumanaChoice (Contract R5826) Submitted to CMS A-05-19-00039
- 09-29-2022
- Texas Claimed or May Have Claimed More Than $30 Million of $9.89 Billion in Federal Funds for Medicaid Uncompensated Care Payments That Did Not Meet Federal and State Requirements
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Highmark Senior Health Company (Contract H3916) Submitted to CMS A-03-19-00001
- 09-28-2022
- Medicare Dialysis Services Provider Compliance Audit - Dialysis Clinic, Inc. A-05-20-00010
- 09-29-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That BlueCross BlueShield of Tennessee, Inc. (Contract H7917) Submitted to CMS A-07-19-01195
- 09-26-2022
- Medicare Advantage Compliance Audit of Diagnosis Codes That Inter Valley Health Plan, Inc. (Contract H0545), Submitted to CMS A-05-18-00020
- 09-23-2022
- Medicare Hospice Provider Compliance Audit: Hospice of Palm Beach County, Inc. A-02-20-01001
- 09-22-2022
- CMS's System Edits Significantly Reduced Improper Payments to Acute-Care Hospitals After May 2019 for Outpatient Services Provided to Beneficiaries Who Were Inpatients of Other Facilities A-09-22-03007
- 09-21-2022
- End-Stage Renal Disease Network Organizations' Reported Actions Taken in Response to the COVID-19 Pandemic A-05-20-00051
- 09-20-2022
- New York Generally Determined Eligibility for Its Basic Health Program Enrollees in Accordance With Program Requirements A-02-20-01028
- 09-19-2022
- Nearly All States Made Capitation Payments for Beneficiaries Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Two States A-05-20-00025
- Medicare Part B Overpaid and Beneficiaries Incurred Cost-Share Overcharges of Over $1 Million for the Same Professional Services A-06-21-05003
- 09-15-2022
- Certain Life Care Nursing Homes May Not Have Complied With Federal Requirements for Infection Prevention and Control and Emergency Preparedness A-01-20-00004
- 09-14-2022
- Tennessee Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-21-06096
- 09-13-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Regence BlueCross BlueShield of Oregon (Contract H3817) Submitted to CMS A-09-20-03009
- 09-12-2022
- New York Claimed $196 Million, Over 72 Percent of the Audited Amount, in Federal Reimbursement for NEMT Payments to New York City Transportation Providers That Did Not Meet or May Not Have Met Medicaid Requirements A-02-21-01001
- 08-29-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That WellCare of Florida, Inc., (Contract H1032) Submitted to CMS A-04-19-07084
- 08-26-2022
- Montana Claimed Federal Medicaid Reimbursement for More Than $5 Million in Targeted Case Management Services That Did Not Comply With Federal and State Requirements A-07-21-03246
- 08-19-2022
- Medicare Advantage Compliance Audit of Diagnosis Codes That Cigna HealthSpring of Florida, Inc. (Contract H5410) Submitted to CMS A-03-18-00002
- 08-10-2022
- South Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-21-07003
- 07-27-2022
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2021 A-18-22-11300
- 07-26-2022
- Certain Nursing Homes May Not Have Complied With Federal Requirements for Infection Prevention and Control and Emergency Preparedness A-01-20-00005
- 07-25-2022
- CMS Reported Collecting Just Over Half of the $498 Million in Medicare Overpayments Identified by OIG Audits A-04-18-03085
- 07-19-2022
- Medicare Critical Care Services Provider Compliance Audit: Lahey Clinic, Inc. A-03-20-00002
- 07-18-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cariten Health Plan, Inc., (Contract H4461) Submitted to CMS A-02-20-01009
- 07-15-2022
- Audits of Nursing Home Life Safety and Emergency Preparedness in Eight States Identified Noncompliance With Federal Requirements and Opportunities for the Centers for Medicare & Medicaid Services to Improve Resident, Visitor, and Staff Safety A-02-21-01010
- 07-14-2022
- Medicare Hospice Provider Compliance Audit: Vitas Healthcare Corporation of Florida A-02-19-01018
- 07-05-2022
- The Reduced Outlier Threshold Applied to Transfer Claims Did Not Significantly Increase Medicare Payments to Hospitals A-05-19-00019
- 06-29-2022
- The Centers for Medicare & Medicaid Services Had Policies and Procedures in Place To Mitigate Vulnerabilities in a Timely Manner, but Improvements Are Needed A-18-20-06500
- 06-23-2022
- More Than 90 Percent of the New Hampshire Managed Care Organization and Fee-for-Service Claims for Opioid Treatment Program Services Did Not Comply With Medicaid Requirements A-01-20-00006
- An Estimated 91 Percent of Nursing Home Staff Nationwide Received the Required COVID-19 Vaccine Doses, and an Estimated 56 Percent of Staff Nationwide Received a Booster Dose A-09-22-02003
- 06-10-2022
- Medicare and Beneficiaries Paid Substantially More to Provider-Based Facilities in Eight Selected States in Calendar Years 2010 Through 2017 Than They Paid to Freestanding Facilities in the Same States for the Same Type of Services A-07-18-02815
- 06-06-2022
- Maine Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents A-01-20-00007
- 05-25-2022
- Texas Did Not Report and Return All Medicaid Overpayments for the State's Medicaid Fraud Control Unit's Cases A-06-20-04004
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Peoples Health Network (Contract H1961) Submitted to CMS A-06-18-05002
- Vanderbilt University Medical Center: Audit of Outpatient Outlier Payments A-06-20-04003
- 05-31-2022
- Medicare Improperly Paid Durable Medical Equipment Suppliers an Estimated $8 Million of the $40 Million Paid for Power Mobility Device Repairs A-09-20-03016
- 05-24-2022
- Selected Dialysis Companies Implemented Additional Infection Control Policies and Procedures To Protect Beneficiaries and Employees During the COVID-19 Pandemic A-05-20-00052
- 05-13-2022
- Washington State Did Not Comply With Federal and State Requirements for Claiming Enhanced Federal Reimbursement for Medicaid Managed-Care Health Home Service Expenditures A-09-20-02008
- 04-25-2022
- Massachusetts Implemented Our Prior Audit Recommendations and Generally Complied With Federal and State Requirements for Reporting and Monitoring Critical Incidents A-01-20-00003
- 04-20-2022
- California Improperly Claimed at Least $23 Million of $260 Million in Total Medicaid Reimbursement for Opioid Treatment Program Services A-09-20-02009
- 04-07-2022
- Posthospital Skilled Nursing Facility Care Provided to Dually Eligible Beneficiaries in Indiana Generally Met Medicare Level-of-Care Requirements A-05-20-00005
- 04-01-2022
- South Carolina Did Not Fully Comply With Requirements for Reporting and Monitoring Critical Events Involving Medicaid Beneficiaries With Developmental Disabilities A-04-18-07078
- 03-29-2022
- Psychotherapy Services Billed by a New York City Provider Did Not Comply With Medicare Requirements A-02-21-01006
- 03-14-2022
- New Mexico Did Not Claim $12.4 Million of $222.6 Million in Medicaid Payments for Services Provided by Indian Health Service Facilities in Accordance With Federal and State Requirements A-06-19-09005
- 03-08-2022
- New Jersey's Medicaid School-Based Cost Settlement Process Could Result in Claims That Do Not Meet Federal Requirements A-02-20-01012
- 03-02-2022
- The Centers for Medicare & Medicaid Services' Eligibility Review Contractor Adequately Determined Medicaid Eligibility for Selected States Under the Payment Error Rate Measurement Program A-02-20-01006
- 02-22-2022
- Hospitals Did Not Always Meet Differing Medicare Contractor Specifications for Bariatric Surgery A-09-20-03007
- 02-18-2022
- Office of Inspector General's Partnership With the Oregon Secretary of State's Audits Division: Oregon Health Authority-Timely Notification of Inpatient Hospital Stays Could Help Reduce Improper Medicaid Payments A-09-22-02001
- 02-15-2022
- New York Verified That Medicaid Assisted Living Program Providers Met Life Safety and Emergency Planning Requirements But Did Not Always Ensure That Assisted Living Program Services Met Federal and State Requirements A-02-19-01017
- 02-14-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Tufts Health Plan (Contract H2256) Submitted to CMS A-01-19-00500
- Medicare Payments of $6.6 Billion to Nonhospice Providers Over 10 Years for Items and Services Provided to Hospice Beneficiaries Suggest the Need for Increased Oversight A-09-20-03015
- 02-03-2022
- Medicare Advantage Compliance Audit of Diagnosis Codes That SCAN Health Plan (Contract H5425) Submitted to CMS A-07-17-01169
- 02-01-2022
- Prior Audits of Medicaid Eligibility Determinations in Four States Identified Millions of Beneficiaries Who Did Not or May Not Have Met Eligibility Requirements A-02-20-01018
- 01-24-2022
- Independent Attestation Review: Centers for Medicare & Medicaid Services Fiscal Year 2021 Detailed Accounting Submission and Budget Formulation Compliance Report for National Drug Control Activities, and Accompanying Required Assertions A-03-22-00351
- 01-05-2022
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Healthfirst Health Plan, Inc., (Contract H3359) Submitted to CMS A-02-18-01029
- 01-04-2022
- Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Assets as of December 31, 2016 A-07-21-00603
- Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2014 Through 2016 A-07-21-00602
- Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals for Calendar Years 2014 Through 2016 A-07-21-00605
- Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Postretirement Benefit Assets as of January 1, 2017 A-07-21-00604
2021
- 12-22-2021
- Arkansas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-01003
- 12-16-2021
- Trends in Genetic Tests Provided Under Medicare Part B Indicate Areas of Possible Concern A-09-20-03027
- Medicare Hospital Provider Compliance Audit: St. Joseph's Hospital Health Center A-02-20-01004
- 12-07-2021
- Medicare Could Have Saved Approximately $993 Million in 2017 and 2018 if It Had Implemented an Inpatient Rehabilitation Facility Transfer Payment Policy for Early Discharges to Home Health Agencies A-01-20-00501
- 12-03-2021
- Medicare Improperly Paid Physicians for Spinal Facet-Joint Denervation Sessions A-09-21-03002
- 12-02-2021
- Kentucky Made Almost $2 Million in Unallowable Capitation Payments for Beneficiaries With Multiple Medicaid ID Numbers A-04-20-07094
- 11-22-2021
- CMS Should Strengthen Its Prescription Drug Event Guidance To Clarify Reporting of Sponsor Margin for Medicare Part D Bids A-03-17-00001
- 11-17-2021
- Missouri Properly Converted Provisionally Enrolled Medicaid Providers to Permanent Providers A-07-21-03248
- 11-16-2021
- Medicare Improperly Paid Suppliers an Estimated $117 Million Over 4 Years for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Hospice Beneficiaries A-09-20-03026
- 11-05-2021
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UPMC Health Plan, Inc. (Contract H3907) Submitted to CMS A-07-19-01188
- 10-28-2021
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health Care of Missouri, Inc. (Contract H2663) Submitted to CMS A-07-17-01173
- 10-25-2021
- Office of Inspector General's Partnership With the Commonwealth of Massachusetts Office of the State Auditor: Office of Medicaid (MassHealth) - Payments for Hospice-Related Services for Dual-Eligible Members A-01-20-00001
- 10-21-2021
- Michigan Did Not Report Calendar Year 2019 Medicaid Third-Party Liability Cost Avoidance Data to the Centers for Medicare & Medicaid Services A-05-20-00058
- 10-19-2021
- Tennessee Medicaid Claimed Hundreds of Millions of Federal Funds for Certified Public Expenditures That Were Not in Compliance With Federal Requirements A-04-19-04070
- 10-13-2021
- Changes Made to States' Medicaid Programs To Ensure Beneficiary Access to Prescriptions During the COVID-19 Pandemic A-06-20-04007
- 10-01-2021
- Medicare Overpaid $636 Million for Neurostimulator Implantation Surgeries A-01-18-00500
- 09-24-2021
- Six of Eight Home Health Agency Providers Had Infection Control Policies and Procedures That Complied With CMS Requirements and Followed CMS COVID-19 Guidance To Safeguard Medicare Beneficiaries, Caregivers, and Staff During the COVID-19 Pandemic A-01-20-00508
- 09-22-2021
- California Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-09-19-02004
- 09-21-2021
- About Seventy-Nine Percent of Opioid Treatment Program Services Provided to Medicaid Beneficiaries in Colorado Did Not Meet Federal and State Requirements A-07-20-04118
- 09-20-2021
- Minnesota Medicaid Managed Care Entities Used a Majority of Medicaid Funds Received for Medical Expenses and Quality Improvement Activities A-05-18-00018
- 09-08-2021
- Colorado Did Not Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-07-17-06075
- 09-07-2021
- An Ophthalmology Clinic in Florida: Audit of Medicare Payments for Eye Injections of Avastin, Eylea, and Lucentis A-09-19-03025
- 09-01-2021
- CMS's COVID-19 Data Included Required Information From the Vast Majority of Nursing Homes, but CMS Could Take Actions To Improve Completeness and Accuracy of the Data A-09-20-02005
- Kansas Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-07-20-05125
- 08-25-2021
- CGS Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-21-00613
- CMS Needs To Issue Regulations Related to Phlebotomy Travel Allowances A-06-20-04000
- CGS Administrators, LLC, Claimed Some Unallowable Medicare Excess Plan Costs Through Its Incurred Cost Proposals A-07-21-00612
- 08-18-2021
- Medicare Home Health Agency Provider Compliance Audit: Catholic Home Care A-02-19-01013
- Medicare Hospital Provider Compliance Audit: Jewish Hospital A-04-19-08077
- CGS Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-20-00593
- CGS Administrators, LLC, Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan III Costs Through Its Incurred Cost Proposals A-07-21-00608
- 08-13-2021
- Medicare Paid New Hospitals Three Times More for Their Capital Costs Than They Would Have Been Paid Under the Inpatient Prospective Payment System A-07-19-02818
- 08-12-2021
- Oklahoma's Oversight of Medicaid Outpatient Services for Opioid Use Disorder Was Generally Effective A-06-20-08000
- Missouri Claimed Federal Reimbursement for $3.4 Million in Payments to Health Home Providers That Did Not Meet Medicaid Requirements A-07-20-04117
- 08-10-2021
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Excess Plan Costs Through Its Incurred Cost Proposals A-07-21-00616
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan III Costs Through Its Incurred Cost Proposals A-07-21-00615
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-21-00614
- Companion Data Services, LLC, Supplemental Executive Retirement Plan III Costs Claimed Through Incurred Cost Proposals Were Allowable and Reasonable A-07-21-00611
- Companion Data Services, LLC, Claimed Some Unallowable Medicare Excess Plan Costs Through Its Incurred Cost Proposals A-07-21-00610
- Companion Data Services, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-21-00609
- Palmetto Government Benefits Administrator, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-20-00592
- 08-06-2021
- Almost All of the Medicare Pension Costs That Companion Data Services, LLC, Claimed Through Its Incurred Cost Proposals Were Allowable A-07-20-00594
- Medicare Continues To Make Overpayments for Chronic Care Management Services, Costing the Program and Its Beneficiaries Millions of Dollars A-07-19-05122
- 07-28-2021
- Almost 15 Percent of Arkansas' Private Contractor Costs Were Either Unallowable or Claimed at Higher Federal Matching Rates Than Eligible, Resulting in Arkansas Inappropriately Claiming $4.4 Million in Federal Medicaid Funds A-06-18-09002
- 07-21-2021
- Texas Made Unallowable Children's Health Insurance Program Payments for Beneficiaries Assigned More Than One Identification Number A-06-20-10003
- 07-20-2021
- Palmetto GBA, LLC, Accurately Calculated Hospice Cap Amounts but Did Not Collect All Cap Overpayments A-06-19-08003
- New York Improperly Claimed $439 Million In Medicaid Funds for Its School-Based Health Services Based on Certified Public Expenditures A-02-18-01019
- 07-12-2021
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2020 A-18-21-11300
- Audit of Medicare Part D Pharmacy Fees: Group Health Cooperative, Inc. A-03-19-00002
- Medicare Hospice Provider Compliance Audit: Partners In Care, Inc. A-09-18-03024
- 07-08-2021
- Medicare Hospice Provider Compliance Audit: Mission Hospice & Home Care, Inc. A-09-18-03009
- The Centers for Medicare & Medicaid Services Did Not Account for National Security Risks in Its Enterprise Risk Management Processes A-18-20-06200
- 07-07-2021
- Medicare Payments for Transitional Care Management Services Generally Complied With Federal Requirements, but Some Overpayments Were Made A-07-17-05100
- New York's Claims for Federal Reimbursement for Payments to Health Home Providers on Behalf of Beneficiaries Diagnosed With Serious Mental Illness or Substance Use Disorder Generally Met Medicaid Requirements But It Still Made $6 Million in Improper Payments to Some Providers A-02-19-01007
- 06-30-2021
- Indiana Received Over $22 Million in Excess Federal Funds Related to Unsupported Community Integration and Habilitation Waiver Services at 12 Selected Service Providers A-05-19-00022
- Medicare Hospital Provider Compliance Audit: Lake Hospital System A-05-19-00024
- 06-24-2021
- CMS's Controls Related to Hospital Preparedness for an Emerging Infectious Disease Were Well-Designed and Implemented but Its Authority Is Not Sufficient for It To Ensure Preparedness at Accredited Hospitals A-02-21-01003
- Medicare Hospital Provider Compliance Audit: Staten Island University Hospital A-02-18-01025
- Kentucky Claimed Millions in Unallowable School-Based Medicaid Administrative Costs A-04-17-00113
- 06-23-2021
- Medicare Hospice Provider Compliance Audit: Northwest Hospice, LLC A-09-20-03035
- 06-10-2021
- Nebraska Did Not Report and Refund the Correct Federal Share of Medicaid-Related Overpayments for 76 Percent of the State's Medicaid Fraud Control Unit Cases A-07-18-02814
- Medicare Hospice Provider Compliance Audit: Professional Healthcare at Home, LLC A-09-18-03028
- 06-09-2021
- California Did Not Ensure That Nursing Facilities Always Reported Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Properly A-09-19-02005
- 06-08-2021
- Opportunities Exist for CMS and Its Medicare Contractors To Strengthen Program Safeguards To Prevent and Detect Improper Payments for Drug Testing Services A-09-20-03017
- 06-03-2021
- University of Michigan Health System: Audit of Medicare Payments for Polysomnography Services A-04-20-07088
- 06-02-2021
- New Mexico Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-06-16-00001
- 05-28-2021
- Medicare Home Health Agency Provider Compliance Audit: Caretenders of Jacksonville, LLC A-04-16-06195
- 05-25-2021
- Blue Cross Blue Shield of South Carolina Overstated Its Excess Plan Partial Medicare Segment Pension Assets as of January 1, 2017 A-07-21-00607
- 05-24-2021
- Medicare Made Millions of Dollars in Overpayments for End-Stage Renal Disease Monthly Capitation Payments A-07-19-05117
- 05-21-2021
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Anthem Community Insurance Company, Inc. (Contract H3655) Submitted to CMS A-07-19-01187
- 05-20-2021
- Sleep Management, LLC: Audit of Claims for Monthly Rental of Noninvasive Home Ventilators A-04-18-04066
- 05-18-2021
- Medicare Hospice Provider Compliance Audit: Franciscan Hospice A-09-20-03034
- 05-14-2021
- Medicare Hospice Provider Compliance Audit: Alive Hospice, Inc. A-09-18-03016
- Medicare Hospice Provider Compliance Audit: Ambercare Hospice, Inc. A-09-18-03017
- 05-13-2021
- CMS Needs to Strengthen Regulatory Requirements for Medicare Part B Outpatient Cardiac and Pulmonary Rehabilitation Services to Ensure Providers Fully Meet Coverage Requirements A-02-18-01026
- 05-11-2021
- New York Made Unallowable Payments Totaling More Than $9 Million to the Same Managed Care Organization for Beneficiaries Assigned More Than One Medicaid Identification Number A-02-20-01007
- Medicare Could Have Saved up to $20 Million Over 5 Years if CMS Oversight Had Been Adequate To Prevent Payments for Medically Unnecessary Cholesterol Blood Tests A-09-19-03027
- 05-07-2021
- Medicare Hospice Provider Compliance Audit: Suncoast Hospice A-02-18-01001
- 05-06-2021
- Minnesota Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00032
- 05-05-2021
- Louisiana Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-02005
- 05-04-2021
- Medicare Hospital Provider Compliance Audit: Virtua Our Lady of Lourdes Hospital A-02-18-01018
- 04-27-2021
- Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Maryland A-03-17-00009
- 04-21-2021
- Office of Inspector General's Partnership with the Office of the New York State Comptroller: Improper Medicaid Payments for Individuals Receiving Hospice Services Covered by Medicare A-02-21-01008
- 04-19-2021
- Medicare Advantage Compliance Audit of Diagnosis Codes That Humana, Inc., (Contract H1036) Submitted to CMS A-07-16-01165
- 04-12-2021
- Georgia Generally Ensured That Nursing Facilities Reported Allegations of Potential Abuse or Neglect of Medicaid Beneficiaries and Prioritized Allegations Timely A-04-17-03084
- 04-08-2021
- Blue Cross Blue Shield of South Carolina Overstated Its Supplemental Executive Retirement Plan III Medicare Allowable Segment Pension Assets as of January 1, 2017 A-07-20-00600
- 04-08-2021
- Palmetto Government Benefits Administrator, LLC, Overstated Its Excess Plan Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00598
- 04-07-2021
- Noridian Healthcare Solutions, LLC, Claimed Unallowable Medicare Nonqualified Restoration Savings Plan Costs Through Its Incurred Cost Proposals A-07-20-00591
- 03-31-2021
- Medicare Hospital Provider Compliance Audit: Sunrise Hospital & Medical Center A-04-19-08075
- 03-29-2021
- Louisiana Appropriately Claimed Most Balancing Incentive Payment Program Funds A-06-19-02000
- 03-23-2021
- Companion Data Services, LLC, Properly Updated Its Excess Plan Medicare Segment Pension Assets as of January 1, 2017 A-07-21-00606
- 03-29-2021
- An Ophthalmology Clinic in California: Audit of Medicare Payments for Eye Injections of Eylea and Lucentis A-09-19-03022
- 03-17-2021
- North Mississippi Medical Center: Audit of Medicare Payments for Polysomnography Services A-04-19-07086
- 03-04-2021
- Peninsula Regional Medical Center: Audit of Medicare Payments for Polysomnography Services A-04-19-07087
- Florida Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Assess, Prioritize, or Investigate Reported Incidents A-04-17-08058
- 03-01-2021
- CMS Authorized Hundreds of Millions of Dollars in Advanced Premium Tax Credits on Behalf of Enrollees Who Did Not Make Their Required Premium Payments A-02-19-02005
- 02-25-2021
- Medicare Home Health Agency Provider Compliance Audit: Brookdale Home Health, LLC A-04-18-06221
- 02-24-2021
- Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Blue Cross Blue Shield of Michigan (Contract H9572) Submitted to CMS A-02-18-01028
- 02-22-2021
- Medicare Hospice Provider Compliance Audit: Tidewell Hospice, Inc. A-02-18-01024
- 02-19-2021
- Noridian Healthcare Solutions, LLC, Made Improper Medicare Payments of $4 Million to Physicians in Jurisdiction E for Spinal Facet-Joint Injections A-09-20-03010
- 02-16-2021
- New York Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-02-17-01026
- Iowa Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-07-19-03238
- 02-03-2021
- Illinois Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00031
- 01-27-2021
- Louisiana Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries A-06-18-02000
- 01-25-2021
- California Claimed at Least $2 Million in Unallowable Medicaid Reimbursement for a Selected Provider's Opioid Treatment Program Services A-09-20-02001
- 01-21-2021
- Massachusetts Made at Least $14 Million in Improper Medicaid Payments for the Nonemergency Medical Transportation Program A-01-19-00004
- 01-15-2021
- CMS and Its Contractors Did Not Use Comprehensive Error Rate Testing Program Data To Identify and Focus on Error-Prone Providers A-05-17-00023
- 01-13-2021
- Medicare Home Health Agency Provider Compliance Audit: Southeastern Home Health Services A-03-17-00004
2020
- 12-30-2020
- The Centers for Medicare & Medicaid Services Could Improve Its Wage Index Adjustment for Hospitals in Areas With the Lowest Wages
- 12-22-2020
- Medicare Home Health Agency Provider Compliance Audit: Tender Touch Health Care Services A-04-18-07077
- 12-21-2020
- Aspects of Texas' Quality Incentive Payment Program Raise Questions About Its Ability To Promote Economy and Efficiency in the Medicaid Program A-06-18-07001
- 12-16-2020
- Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Tullahoma, Tennessee A-02-16-01024
- 12-16-2020
- Medicare Hospital Provider Compliance Audit: Providence Medical Center A-07-18-05113
- 12-11-2020
- Risk Assessment Puerto Rico Medicaid Program A-02-20-01011
- 12-09-2020
- New York Improved Its Monitoring of Its Personal Care Services Program But Still Made Improper Medicaid Payments of More Than $54 Million A-02-19-01016
- 12-07-2020
- Medicare Home Health Agency Provider Compliance Audit: Total Patient Care Home Health, LLC A-06-16-05005
- 12-01-2020
- Nebraska Claimed Almost All Medicaid Payments for Targeted Case Management Services in Accordance With Federal Requirements but Claimed Some Unallowable Duplicate Payments A-07-19-03239
- 11-24-2020
- Florida Received Unallowable Medicaid Reimbursement for School-Based Services A-04-18-07075
- 11-19-2020
- Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Payson, Arizona. A-02-16-01023
- 11-18-2020
- Medicare Home Health Agency Provider Compliance Audit: The Palace at Home A-04-17-07067
- 11-17-2020
- Cahaba Government Benefits Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00577
- Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00578
- 11-16-2020
- Hospitals Did Not Comply With Medicare Requirements for Reporting Cardiac Device Credits A-01-18-00502
- 11-12-2020
- Ohio Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State A-05-19-00023
- Medicare Hospital Provider Compliance Audit: Edward W. Sparrow Hospital A-05-18-00045
- 11-10-2020
- Ohio Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries A-05-18-00027
- 11-05-2020
- Cahaba Government Benefits Administrators, LLC, Did Not Claim Some Allowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00575
- Cahaba Safeguard Administrators, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-19-00576
- 11-04-2020
- CMS Did Not Ensure That Medicare Hospital Payments for Claims That Included Medical Device Credits Were Reduced in Accordance With Federal Regulations, Resulting in as Much as $35 Million in Overpayments A-07-19-00560
- 10-29-2020
- Medicare Home Health Agency Provider Compliance Audit: Visiting Nurse Association of Central Jersey Home Care and Hospice, Inc. A-02-17-01025
- 10-22-2020
- Massachusetts Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-06-18-04001
- 10-21-2020
- Minnesota Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00018
- 10-16-2020
- Medicare Home Health Agency Provider Compliance Audit: Gem City Home Care, LLC A-05-18-00011
- Medicare Hospital Provider Compliance Audit: St Francis Hospital A-05-18-00048
- 10-14-2020
- Cedars-Sinai Medical Center: Audit of Medicare Payments for Bariatric Surgeries A-09-18-03010
- 10-09-2020
- Medicare Improperly Paid Physicians for More Than Five Spinal Facet-Joint Injection Sessions During a Rolling 12-Month Period A-09-20-03003
- 10-07-2020
- Update on Oversight of Opioid Prescribing and Monitoring of Opioid Use: States Have Taken Action To Address the Opioid Epidemic A-09-20-01000
- 10-02-2020
- Colorado Improperly Claimed Millions in Enhanced Federal Medicaid Reimbursement for New Adult Group Beneficiaries Because of a Data Processing Error A-07-17-02807
- Medicare Critical Care Services Provider Compliance Audit: Clinical Practices of the University of Pennsylvania A-03-18-00003
- 09-30-2020
- Medicare Hospital Provider Compliance Audit: Alta Bates Summit Medical Center A-04-19-08071
- 09-25-2020
- North Carolina Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-04-16-00112
- 09-22-2020
- Oregon's Oversight Did Not Ensure That Four Coordinated-Care Organizations Complied With Selected Medicaid Requirements Related to Access to Care and Quality of Care A-09-18-03035
- CMS's Monitoring Activities for Ensuring That Medicare Accountable Care Organizations Report Complete and Accurate Data on Quality Measures Were Generally Effective, but There Were Weaknesses That Could Be Improved A-09-18-03033
- 09-21-2020
- Connecticut Did Not Meet Federal and State Requirements for Claiming Medicaid School-Based Child Health Services for Hartford Public Schools A-01-19-00003
- 09-18-2020
- North Carolina Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-19-08070
- Vermont Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-19-06086
- 09-17-2020
- Illinois Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-05-18-00037
- 09-16-2020
- Incorrect Acute Stroke Diagnosis Codes Submitted by Traditional Medicare Providers Resulted in Millions of Dollars in Increased Payments to Medicare Advantage Organizations A-07-17-01176
- Medicare-Allowed Charges for Noninvasive Ventilators Are Substantially Higher Than Payment Rates of Select Non-Medicare Payers A-05-20-00008
- Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals A-07-20-00590
- 09-14-2020
- Maine Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs A-07-18-06079
- 09-11-2020
- Medicare Home Health Agency Provider Compliance Audit: Mercy Health Visiting Nurse Services A-05-18-00035
- Group Health Incorporated Overstated Its Allowable Medicare Supplemental Executive Retirement Plan Costs for Calendar Years 2009 Through 2016 A-07-19-00582
- Group Health Incorporated Claimed Some Unallowable Medicare Postretirement Benefit Costs for Calendar Years 2009 Through 2016 A-07-19-00583
- Group Health Incorporated Overstated Its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of December 31, 2015 A-07-19-00579
- Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Assets and Understated Medicare's Share of the Medicare Segment Pension Assets as of August 31, 2016 A-07-19-00580
- Group Health Incorporated Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2009 Through 2016 A-07-19-00581
- 09-08-2020
- Indiana Did Not Ensure That Medicaid Payments Were Made Properly for Some Claims Identified as Having Third-Party Coverage A-05-18-00046
- 09-04-2020
- Audit of Medicare Part D Pharmacy Fees: Horizon Blue Cross Blue Shield, Inc. A-03-18-00007
- 09-03-2020
- Baylor Scott & White—College Station: Audit of Outpatient Outlier Payments A-06-18-04003
- 09-01-2020
- Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group A-07-19-02822
- Medicare Hospital Provider Compliance Audit: Flagstaff Medical Center A-07-18-05112
- 08-27-2020
- Texas Relied on Impermissible Provider-Related Donations To Fund the State Share of the Medicaid Delivery System Reform Incentive Payment Program A-06-17-09002
- 08-25-2020
- Michigan Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-05-17-00017
- Illinois Claimed Unallowable Telemedicine Payments A-05-18-00028
- Indiana Paid $3.5 Million for Medicaid Nonemergency Medical Transport Claims That Did Not Comply With Federal and State Requirements A-05-18-00043
- Medicare Contractors Were Not Consistent in How They Reviewed Extrapolated Overpayments in the Provider Appeals Process A-05-18-00024
- 08-21-2020
- CMS Generally Met Requirements for the DMEPOS Competitive Bidding Program Round 1 Recompete A-05-16-00051
- 08-19-2020
- New Jersey Did Not Ensure That Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries Residing in Nursing Facilities Were Always Properly Investigated and Reported A-02-18-01006
- 08-18-2020
- Indiana Properly Reported Adjustments Related to the Drug Rebate Program A-05-19-00028
- 08-14-2020
- Nebraska Claimed Unallowable School-Based Administrative Costs Because of Improper Coding of Random Moment Timestudy Responses A-07-19-03234
- 08-11-2020
- Medicare Home Health Agency Provider Compliance Audit: Mission Home Health of San Diego, Inc. A-09-18-03008
- 08-10-2020
- Visionquest Industries, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03010
- Medicare Home Health Agency Provider Compliance Audit: Condado Home Care Program, Inc. A-02-17-01022
- 08-06-2020
- Desoto Home Health Care, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03021
- 08-05-2020
- Inadequate Edits and Oversight Caused Medicare To Overpay More Than $267 Million for Hospital Inpatient Claims With Post-Acute-Care Transfers to Home Health Services A-04-18-04067
- 08-04-2020
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2019 A-18-20-11300
- 07-29-2020
- North Carolina Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse and Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Timely A-04-17-04063
- 07-27-2020
- The New York State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-04-19-06223
- 07-24-2020
- Factsheet: Ohio's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-05-19-00036
- 07-22-2020
- CMS Could Have Saved $192 Million by Targeting Home Health Claims for Review With Visits Slightly Above the Threshold That Triggers a Higher Medicare Payment A-09-18-03031
- 07-21-2020
- On-Site Psychological Services, P.C.: Audit of Medicare Payments for Psychotherapy Services A-02-19-01012
- Alaska Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-09-19-02001
- 07-15-2020
- CMS Did Not Administer and Manage Strategic Communications Services Contracts in Accordance With Federal Requirements A-12-19-20003
- 07-13-2020
- Hospitals Overbilled Medicare $1 Billion by Incorrectly Assigning Severe Malnutrition Diagnosis Codes to Inpatient Hospital Claims A-03-17-00010
- 07-10-2020
- Medicaid Data Can Be Used To Identify Instances of Potential Child Abuse or Neglect A-01-19-00001
- 07-09-2020
- Texas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-06-17-04003
- 07-06-2020
- Freedom Orthotics, Inc.: Audit of Medicare Payments for Orthotic Braces A-09-19-03012
- 06-03-2020
- Texas Telemedicine Services Were Provided in Accordance with State Requirements A-06-18-05001
- 06-01-2020
- New Jersey Did Not Ensure That Its Managed Care Organizations Adequately Assessed and Covered Medicaid Beneficiaries' Needs for Long-Term Services and Supports A-02-17-01018
- 05-22-2020
- Medicare Hospital Provider Compliance Audit: The Ohio State University Hospital A-05-18-00042
- 05-01-2020
- Medicare Made $11.7 Million in Overpayments for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays A-01-17-00508
- 04-29-2020
- North Carolina Received $30 Million in Excess Federal Funds Related to Improperly Claimed Health Home Expenditures A-04-18-00120
- 04-20-2020
- Grand Desert Psychiatric Services: Audit of Medicare Payments for Psychotherapy Services A-09-19-03018
- 04-17-2020
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs A-07-20-00589
- Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Pension Costs A-07-20-00588
- Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00587
- Palmetto Government Benefits Administrator, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-20-00586
- 04-16-2020
- Recommendation Followup: Michigan Did Not Report and Refund the Full Federal Share of Medicaid Overpayments A-05-18-00022
- 04-09-2020
- Medicare Home Health Agency Provider Compliance Audit: Residential Home Health A-05-16-00063
- An Estimated 87 Percent of Inpatient Psychiatric Facility Claims With Outlier Payments Did Not Meet Medicare's Medical Necessity or Documentation Requirements A-01-16-00508
- 04-07-2020
- New York Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations A-02-18-01016
- Iowa Inadequately Monitored Its Medicaid Health Home Providers, Resulting in Tens of Millions in Improperly Claimed Reimbursement A-07-18-04109
- 04-01-2020
- 96 Percent of South Carolina's Medicaid Fee-for-Service Telemedicine Payments Were Insufficiently Documented or Otherwise Unallowable A-04-18-00122
- 03-27-2020
- Medicare Hospital Provider Compliance Audit: Forbes Hospital A-03-18-00005
- Iowa Did Not Comply With Federal and State Requirements for Major Incidents Involving Medicaid Members With Developmental Disabilities A-07-18-06081
- 03-26-2020
- New York's Oversight of Medicaid Managed Care Organizations Did Not Ensure Providers Complied With Health and Safety Requirements at 18 of 20 Adult Day Care Facilities Reviewed A-02-18-01027
- 03-25-2020
- Medicare Dialysis Services Provider Compliance Review: Bio-Medical Applications of Arecibo, Inc. A-02-17-01016
- 03-24-2020
- Most of the Non-Newly Eligible Beneficiaries for Whom Colorado Made Medicaid Payments Met Federal and State Requirements, but Documentation Supporting That All Eligibility Requirements Were Verified Properly Was Not Always in Place A-07-18-02812
- 03-23-2020
- Florida Made Almost $4 Million in Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid ID Numbers A-04-18-07080
- 03-17-2020
- CMS Could Take Actions To Help States Comply With Federal Requirements Prohibiting Medicaid Payments for Inpatient Hospital Services Related to Provider-Preventable Conditions A-09-18-02004
- 03-13-2020
- Missouri Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-07-18-03230
- 03-06-2020
- Florida Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-04-18-08065
- 03-03-2020
- Factsheet: Kentucky's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-04-19-02022
- 03-02-2020
- Medicare Hospital Provider Compliance Audit: Saint Francis Health Center A-07-17-05102
- 02-28-2020
- The Centers for Medicare & Medicaid Services Did Not Identify and Report Potential Antideficiency Act Violations for 12 Contracts Used To Establish the Federal Marketplace Under the Affordable Care Act A-03-16-03001
- 02-25-2020
- CHI St. Vincent Infirmary: Audit of Outpatient Outlier Payments A-06-16-01002
- 02-20-2020
- New York Made Unallowable Payments Totaling More Than $10 Million for Managed Care Beneficiaries Assigned Multiple Medicaid Identification Numbers A-02-18-01020
- 02-19-2020
- New York Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs A-02-18-01011
- 02-14-2020
- Michigan Made Capitation Payments to Managed Care Entities After Beneficiaries' Deaths A-05-17-00048
- 02-11-2020
- The Majority of Providers Reviewed Used Medicare Part D Eligibility Verification Transactions for Potentially Inappropriate Purposes A-05-17-00020
- 02-07-2020
- The Federal Marketplace Properly Determined Individuals' Eligibility for Enrollment in Qualified Health Plans but Improperly Determined That an Estimated 3 Percent of Individuals Were Eligible for Insurance Affordability Programs A-09-18-01000
- 02-06-2020
- New York Followed Its Approved Methodology for Claiming Enhanced Medicaid Reimbursement Under the Community First Choice Option A-02-17-01015
- 02-06-2020
- Life Safety and Emergency Preparedness Deficiencies Found at 18 of 20 Texas Nursing Homes A-06-19-08001
- 02-04-2020
- New York Claimed Tens of Millions of Dollars for Opioid Treatment Program Services That Did Not Comply With Medicaid Requirements Intended To Ensure the Quality of Care Provided to Beneficiaries A-02-17-01021
- 01-29-2020
- The Indiana State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths A-05-19-00007
- 01-24-2020
- More Than One-Third of New Jersey's Federal Medicaid Reimbursement for Providing Community-Based Treatment Services Was Unallowable A-02-17-01020
- 01-21-2020
- CMS's Implementation of a 2014 Policy Change Resulted in Improvements in the Reporting of Coverage Gap Discounts Under Medicare Part D A-07-16-06067
- 01-17-2020
- Pennsylvania Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities A-03-17-00202
- 01-13-2020
- CMS's Controls Over Assigning Medicare Beneficiary Identifiers and Mailing New Medicare Cards Were Generally Effective but Could Be Improved in Some Areas A-09-19-03003
- 01-09-2020
- New York Improperly Claimed Medicaid Reimbursement for Some Bridges to Health Waiver Program Services That Were Not in Accordance With an Approved Plan of Care and Did Not Meet Documentation Requirements A-02-18-01003
- 12-16-2019
- Novitas Solutions, Inc. Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances A-06-17-04002
- 12-12-2019
- CMS Made an Estimated $93.6 Million in Incorrect Medicare Electronic Health Record Incentive Payments to Acute-Care Hospitals, or Less Than 1 Percent of $10.8 Billion in Total Incentive Payments A-09-18-03020
- 12-10-2019
- Medicare Hospital Provider Compliance Audit: Texas Health Presbyterian Hospital Dallas A-04-18-08068
- 12-05-2019
- Medicare Home Health Agency Provider Compliance Audit: Palos Community Hospital Home Health Agency A-05-17-00022
- 11-27-2019
- Medicare Hospital Provider Compliance Audit: St. Vincent Hospital A-05-18-00040
- Factsheet: Alabama's Oversight of Opioid Prescribing and Monitoring of Opioid Use A-04-19-00125
- 11-26-2019
- Medicare Hospital Provider Compliance Audit: Northwest Medical Center A-04-18-08064
- Medicare Hospital Provider Compliance Audit: Carolinas Hospital A-04-18-08063
- 11-22-2019
- Hospitals Received Millions in Excessive Outlier Payments Because CMS Limits the Reconciliation Process A-05-16-00060
- 11-21-2019
- Noridian Healthcare Solutions, LLC, Did Not Claim Allowable Medicare Nonqualified Costs A-07-19-00574
- Noridian Healthcare Solutions, LLC, Did Not Claim Allowable Medicare Nonqualified Costs Through Its Incurred Cost Proposals A-07-19-00573
- 11-20-2019
- Cahaba Safeguard Administrators, LLC, Properly Updated the Medicare Segment Pension Assets as of January 1, 2017 A-07-19-00571
- Cahaba Government Benefits Administrators, LLC, Overstated Its Medicare Segment Pension Assets as of January 1, 2017 A-07-19-00570
- 11-18-2019
- Registered Nurses Did Not Always Visit Medicare Beneficiaries' Homes At Least Once Every 14 Days To Assess The Quality of Care and Services Provided by Hospice Aides A-09-18-03022
- 11-13-2019
- California Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness A-09-18-02009
- 11-12-2019
- Highlands of Little Rock West Markham Holdings, LLC: Audit of Documentation of Therapy Resource Utilization Groups A-06-18-08003
- 11-08-2019
- New Jersey Improperly Claimed Tens of Millions for Medicaid School-Based Administrative Costs Based on Random Moment Sampling That Did Not Meet Federal Requirements A-02-17-01006
- 11-07-2019
- The University of Minnesota Complied With Federal Requirements To Perform Risk Assessments and Monitor Subrecipients A-05-18-00015
- Medicare Made Hundreds of Thousands of Dollars in Overpayments for Chronic Care Management Services A-07-17-05101
- 11-06-2019
- Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs A-07-19-00569
- Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Postretirement Benefit Costs Through Its Incurred Cost Proposals A-07-19-00568
- Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Postretirement Benefit Assets A-07-19-00567
- Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals A-07-18-00550
- Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Pension Costs A-07-18-00548
- Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Pension Assets A-07-18-00547
- 11-01-2019
- Medicare Improperly Paid Acute-Care Hospitals $54.4 Million for Inpatient Claims Subject to the Post-Acute-Care Transfer Policy A-09-19-03007
- 10-31-2019
- Audit of Medicare Part D Pharmacy Fees: Geisinger Health Systems, Inc. A-03-18-00006
- Medicare Improperly Paid Suppliers an Estimated $92.5 Million for Inhalation Drugs A-09-18-03018
- 10-30-2019
- Medicare Allowable Amounts for Certain Orthotic Devices Are Not Comparable With Payments Made by Select Non-Medicare Payers A-05-17-00033
- Medicare Home Health Agency Provider Compliance Review: Angels Care Home Health A-07-16-05093
- 10-29-2019
- Tennessee Made Unallowable Capitation Payments for Beneficiaries Assigned Multiple Medicaid Identification Numbers A-04-18-07079
- 10-23-2019
- The Centers for Medicare & Medicaid Services Could Improve Its Processes for Evaluating and Reporting Payment Recovery Savings Associated With the Fraud Prevention System A-01-15-00510
- 10-21-2019
- Texas Did Not Ensure That Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-06-16-01001)
- Rhode Island Hospital Submitted Some Inaccurate Wage Data A-01-17-00509
- Sunshine ACO, LLC, Generally Reported Complete and Accurate Data on Quality Measures Through the CMS Web Portal, but There Were a Few Reporting Deficiencies That Did Not Affect the Overall Quality Performance Score (A-09-18-03019)
- 10-01-2019
- The Minnesota State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths (A-05-17-00049)
- 09-30-2019
- Wisconsin Physicians Service Needs Enhanced Guidance and Provider Education Related to Phlebotomy Travel Allowances (A-06-17-04005)
- California Needs To Improve Oversight of Community-Based Adult Services Providers' Compliance With Health and Safety and Administrative Requirements (A-09-18-02002)
- 09-26-2019
- National Government Services, Inc., Did Not Claim Some Medicare Postretirement Benefit Plan Costs Through Its Incurred Cost Proposals (A-07-19-00566)
- National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Incurred Cost Proposals (A-07-19-00572)
- National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs Through Its Incurred Cost Proposals (A-07-19-00564)
- National Government Services, Inc., Claimed Some Unallowable Medicare Supplemental Executive Retirement Plan Costs Through Its Incurred Cost Proposals (A-07-19-00565)
- 09-24-2019
- National Government Services, Inc., Claimed Some Unallowable Medicare Nonqualified Plans Costs Through Its Final Administrative Cost Proposals (A-07-19-00563)
- National Government Services, Inc., Claimed Some Unallowable Supplemental Executive Retirement Plan Costs Through Its Final Administrative Cost Proposals (A-07-18-00551)
- 09-19-2019
- CMS Paid Over $277 Million in Unallowable CHIPRA Bonus Payments Based on Incorrect Enrollment Data (A-04-17-08061)
- 09-12-2019
- Ohio Made Medicaid Capitation Payments That Were Duplicative or Were Improper Based on Beneficiary Eligibility Status or Demographics (A-05-16-00061)
- 09-11-2019
- Medicare Incorrectly Paid Providers for Emergency Ambulance Transports From Hospitals to Skilled Nursing Facilities (A-09-18-03030)
- 09-05-2019
- The Centers for Medicare & Medicaid Services Could Use Comprehensive Error Rate Testing Data To Identify High-Risk Home Health Agencies (A-05-17-00035)
- 08-30-2019
- Twin Palms Received Unallowable Medicare Payments for Chiropractic Services (A-04-16-07065)
- Colorado Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries (A-07-16-04228)
- Florida Medicaid Paid Hundreds of Millions in Unallowable Payments to Jackson Memorial Hospital Under Its Low Income Pool Program (A-04-17-04058)
- New Jersey Did Not Bill Manufacturers for Tens of Millions of Dollars in Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-02-16-01011)
- 08-29-2019
- West Florida ACO, LLC, Generally Reported Complete and Accurate Data on Quality Measures Through the CMS Web Portal, but There Were a Few Reporting Deficiencies That Did Not Affect the Overall Quality Performance Score (A-09-18-03003)
- 08-28-2019
- Oceanside Medical Group Received Unallowable Medicare Payments for Psychotherapy Services (A-09-18-03004)
- 08-22-2019
- Medicare Part D Is Still Paying Millions for Drugs Already Paid for Under the Part A Hospice Benefit (A-06-17-08004)
- 08-21-2019
- Texas Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-06-17-04001)
- 08-20-2019
- Illinois Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries' Deaths (A-05-18-00026)
- Mederi Caretenders Home Health Billed for Home Health Services That Did Not Comply With Medicare Billing Requirements (A-07-16-05092)
- Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2018 (A-18-19-11300)
- New York Incorrectly Claimed Enhanced Federal Medicaid Reimbursement for Some Beneficiaries (A-02-15-01023)
- New York Should Improve Its Oversight of Selected Nursing Homes' Compliance With Federal Requirements for Life Safety and Emergency Preparedness (A-02-17-01027)
- 08-16-2019
- Connecticut Claimed Unallowable Federal Reimbursement for Medicaid Physician-Administered Drugs That Were Not Invoiced to Manufacturers for Rebates (A-07-18-06078)
- 08-09-2019
- Georgia Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries' Deaths (A-04-15-06183)
- 08-07-2019
- Pennsylvania Did Not Ensure That Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions (A-03-16-00205)
- 07-25-2019
- Group Health Incorporated Understated Its EmblemHealth Services Company, LLC, Employees' Retirement Plan Medicare Segment Pension Assets as of January 1, 2015 (A-07-19-00561)
- Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Pension Assets as of January 1, 2015 (A-07-19-00562)
- Group Health Incorporated Understated Its Cash Balance Pension Plan Medicare Segment Pension Assets as of January 1, 2011 (A-07-19-00557)
- 07-24-2019
- Oversight of Opioid Prescribing and Monitoring of Opioid Use: States Have Taken Action To Address the Opioid Epidemic (A-09-18-01005)
- 07-23-2019
- A Resource Guide for Using Diagnosis Codes in Health Insurance Claims To Help Identify Unreported Abuse or Neglect (A-01-19-00502)
- 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)
- 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)