Reports

  • CMS Should Strengthen Its Prescription Drug Event Guidance To Clarify Reporting of Sponsor Margin for Medicare Part D Bids
  • Facility-Initiated Discharges in Nursing Homes Require Further Attention
  • Advisory Opinion 21-18
  • Advisory Opinion 21-17
  • Missouri Properly Converted Provisionally Enrolled Medicaid Providers to Permanent Providers
  • Medicare Improperly Paid Suppliers an Estimated $117 Million Over 4 Years for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provided to Hospice Beneficiaries
  • Characteristics of Separated Children in ORRs Care: June 27, 2018–November 15, 2020
  • Advisory Opinion 21-16
  • Advisory Opinion 21-15
  • The District of Columbia Monitoring Did Not Ensure Child Care Provider Compliance With Criminal Background Check Requirements at 7 of 30 Providers Reviewed
  • Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UPMC Health Plan, Inc. (Contract H3907) Submitted to CMS
  • Michigan Did Not Report Calendar Year 2019 Medicaid Third-Party Liability Cost Avoidance Data to the Centers for Medicare & Medicaid Services
  • Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health Care of Missouri, Inc. (Contract H2663) Submitted to CMS
  • Office of Inspector General Partnership With the Commonwealth of Massachusetts Office of the State Auditor: Office of Medicaid (MassHealth) - Payments for Hospice-Related Services for Dual-Eligible Members
  • Tennessee Medicaid Claimed Hundreds of Millions of Federal Funds for Certified Public Expenditures That Were Not in Compliance With Federal Requirements
  • More Than One-Third of Medicaid-Enrolled Children in Five States Did Not Receive Required Blood Lead Screening Tests
  • Most Medicare beneficiaries received telehealth services only from providers with whom they had an established relationship
  • Changes Made to States Medicaid Programs To Ensure Beneficiary Access to Prescriptions During the COVID-19 Pandemic
  • Minnesota Medicaid Managed Care Entities Used a Majority of Medicaid Funds Received for Medical Expenses and Quality Improvement Activities
  • Medicare Overpaid $636 Million for Neurostimulator Implantation Surgeries
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