Reports

  • Advisory Opinion 20-05
  • CMS Should Pursue Strategies To Increase the Number of At Risk Beneficiaries Acquiring Naloxone Through Medicaid
  • Oregon Oversight Did Not Ensure That Four Coordinated-Care Organizations Complied With Selected Medicaid Requirements Related to Access to Care and Quality of Care
  • Incorrect Acute Stroke Diagnosis Codes Submitted by Traditional Medicare Providers Resulted in Millions of Dollars in Increased Payments to Medicare Advantage Organizations
  • Maine Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs
  • Some Manufacturers Reported Inaccurate Drug Product Data to CMS
  • Billions in Estimated Medicare Advantage Payments From Diagnoses Reported Only on Health Risk Assessments Raise Concerns
  • Audit of Medicare Part D Pharmacy Fees: Horizon Blue Cross Blue Shield, Inc.
  • Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group
  • Medicare Hospital Provider Compliance Audit: Flagstaff Medical Center
  • Tribal Health Programs: Concerns About Background Verifications for Staff Working With Indian Children
  • CMS Generally Met Requirements for the DMEPOS Competitive Bidding Program Round 1 Recompete
  • Indiana Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 17 of 30 Providers Reviewed
  • Michigan Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations
  • Illinois Claimed Unallowable Telemedicine Payments
  • Indiana Paid $3.5 Million for Medicaid Nonemergency Medical Transport Claims That Did Not Comply With Federal and State Requirements
  • Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria Fiscal Year 2021 Inspectors General Coordinated PEPFAR Oversight Plan U.S. Department of Health and Human Services, Office of Inspector General
  • Texas Relied on Impermissible Provider-Related Donations To Fund the State Share of the Medicaid Delivery System Reform Incentive Payment Program
  • Medicare Contractors Were Not Consistent in How They Reviewed Extrapolated Overpayments in the Provider Appeals Process
  • CMS Encounter Data Lack Essential Information That Medicare Advantage Organizations Have the Ability to Collect
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