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All Reports and Publications

All Reports and Publications

The Nation’s Challenge to Combat Durable Medical Equipment Fraud in Medicare

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

Health Share of Oregon Did Not Always Comply With Federal and State Requirements When Denying Prior Authorization Requests

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2026

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

Medicare Home Health Agency Provider Compliance Audit: Deistic Home Health Care, Inc.

Medicare Improperly Paid Physicians an Estimated $15.2 Million for Sacroiliac Joint Injections

Connecticut Generally Claimed Medicaid Reimbursement for Clinical Diagnostic Laboratory Services in Accordance With Federal and State Requirements

Hospice of the Valley - West Received at Least $8.6 Million in Medicare Overpayments

Georgia Claimed at Least $26.1 Million More in Medicaid Reimbursements for Clinical Diagnostic Laboratory Services Than Was Allowed by Federal and State Requirements

Wisconsin Physicians Service Insurance Corporation Made Incorrect Medicare Payments to Providers for Outpatient Services

Colorado Could Improve Its Electronic Visit Verification System and Claimed Federal Medicaid Reimbursement for Millions of Dollars in Personal Care Services That Did Not Comply With Federal and State Requirements

States Have Missed Some Opportunities to Improve Medicaid Managed Care Organizations’ Provider Fraud Referrals

Novitas Solutions, Inc., Improperly Paid Approximately $19.5 Million for Selected Medicare Part B Services Provided to Patients Residing in Nursing Homes

New York Should Improve Its Oversight of Nursing Homes’ Compliance With Background Check Requirements

Part D Plans Generally Include Drugs Commonly Used by Dual-Eligible Enrollees: 2026

Medicare Could Have Saved $255.1 Million Related to Hospice Services for Certain New Hospice Enrollees

CMS’s Processes Were Not Effective in Ensuring the Accuracy of Staffing Information Reported in the Payroll-Based Journal

Jefferson Regional Medical Center Received at Least $4.7 Million in Medicare Overpayments

North Dakota Could Better Ensure That Providers Fully Comply With Federal Waiver and State Health, Safety, and Administrative Requirements at 44 Residential Settings

All Reports and Publications

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