Reports

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes Humana Health Benefit of Louisiana (Contract H1951) Submitted to CMS

  

• Illinois Made Unallowable Managed Care Capitation Payments on Behalf of Incarcerated Medicaid Enrollees

  

• Nine of Thirty Selected Assisted Living Facilities Did Not Comply With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments

  

• Some Selected Health Centers Received Duplicate Reimbursement From HRSA For COVID-19 Testing Services

  

• Trends in Dual-Eligible Enrollees’ Access to Drugs Under Part D, 2011-2025

  

• Medicare Home Health Agency Provider Compliance Audit: Guardian Home Care, LLC

  

• Excluding Noncovered Versions Would Have Substantially Lowered Fourth-Quarter 2025 Part B Payment Amounts for Stelara Biosimilars

  

• Oklahoma Medicaid Fraud Control Unit: 2025 Inspection

  

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

  

• The Indian Health Service Did Not Ensure That Commissioned Corps Officers’ Background Investigations Complied With Federal Requirements

  

• Arkansas Could Better Ensure That Intermediate Care Facilities for Individuals With Intellectual Disabilities Comply With Federal Requirements for Life Safety, Emergency Preparedness, and Infection Control

  

• The National Institutes of Health Generally Implemented the Safe Workplace Federal Reporting Requirement, but Opportunities Exist To Improve the Reporting and Monitoring Processes

  

• Podiatrists Claims for Routine Foot Care Services Did Not Comply With Medicare Requirements

  

• New Jersey Did Not Ensure Providers Complied With Federal and State Requirements at All 20 Adult Day Health Services Facilities Audited

  

• Podiatrists’ Claims for Evaluation and Management Services Did Not Comply With Medicare Requirements

  

• Medicare Improperly Paid Selected Optometrists for Services Provided to Enrollees at Nursing Facilities

  

• Florida Retina Institute Generally Met Medicare Requirements for Ophthalmology Services Provided on the Same Day as Eye Injections

  

• Four of Thirty Selected Dental Providers Did Not Comply With Terms and Conditions and Federal Requirements for Expending Provider Relief Fund Payments

  

• Gaps in NIH’s Oversight Put Millions in Funding for Other Transactions at Greater Risk of Fraud, Waste, or Abuse

  

• Medicare Payments for Continuous Glucose Monitors and Supplies Exceeded Supplier Costs and Retail Market Prices, Indicating Medicare Can Save At Least Tens of Millions of Dollars in One Year