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All Reports and Publications

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

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

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

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

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

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

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

Inaccurate Medicaid Managed Care Provider Directories May Limit Enrollees’ Access to Maternal Health Care

Inaccurate Medicaid Managed Care Network Lists May Compromise State Oversight of Access to Maternal Health Care

Congressional Mandate: Part B Billing Codes for Six Drugs Included Noncovered Self-Administered Versions During January 2025 - March 2026

The Three Largest Medicare Advantage Organizations Denied Requests for Long-Term Acute Care and Inpatient Rehabilitation at Some of the Highest Rates

Medicare Advantage Organizations Overturned Nearly All Appealed Prior Authorization Denials for Skilled Nursing Facility Admission, Raising Concerns About Initial Denials

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

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

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

Psychosocial Characteristics and Their Association With Kidney Transplant Programs Waitlist Rates

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

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