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Connecticut Did Not Always Ensure Selected Nursing Homes Complied With Federal and State Background Check Requirements

Impacts of Vertical Integration in Medicare Part D on Sponsors’ Drug Costs, Pharmacy Reimbursement, and Enrollee Cost Sharing

Unclear Medicare Requirements Led to Differing Interpretations of Inpatient Rehabilitation Facility Documentation, Coverage, and Billing Requirements

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2025

Utilization Trends and Medicare Part B Billing for Office-Based Peripheral Vascular Procedures Raise Questions About Program Integrity

Most Nursing Homes Throughout the United States Do Not Have Adequate or Reliable Emergency Power Systems

Medicare Payments for Positive Airway Pressure Devices Used for the Treatment of Obstructive Sleep Apnea Generally Complied With Medicare Requirements

CMS Could Strengthen Medicare Program Safeguards To Prevent and Detect Potentially Improper Payments for Virtual Check-in and E-visit Services

CMS Has Limited Oversight of Selected Compounded Drugs Prescribed to Medicare Part D Enrollees

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Priority Health (Contract H2320) Submitted to CMS

Louisiana Healthcare Connections Generally Complied With Federal and State Process Requirements When Denying Prior Authorization Requests

Selected Diabetes and Weight Loss Drugs Were Dispensed to Michigan Medicaid Managed Care Enrollees in Accordance With Federal and State Requirements

Medicare Home Health Agency Provider Compliance Audit: VNS Health

Congressional Mandate: Part B Payment Amounts for One Drug Included Noncovered Self-Administered Versions in 2024

Nursing Homes Inappropriately Diagnosed Residents with Schizophrenia to Mask the Misuse of Antipsychotic Drugs

Nursing Homes’ Inappropriate Use of Antipsychotic Drugs Poses a Risk to Residents

Indiana Generally Ensured That Selected Nursing Homes Complied With Federal Background Check Requirements

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Gateway Health Plan, Inc., (Contract H5932) Submitted to CMS

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Blue Cross and Blue Shield of Alabama (Contract H0104) Submitted to CMS

Emergency Department Procedure Codes Used on Medicare Claims for Services Billed With Nonemergency Department Sites of Service Resulted in Over $15 Million in Improper and Potentially Improper Payments

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