Reports

  • Indiana Properly Reported Adjustments Related to the Drug Rebate Program
  • Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2018 Average Sales Prices.
  • Medicare Home Health Agency Provider Compliance Audit: Mission Home Health of San Diego, Inc.
  • Opioid Use in Medicare Part D Continued To Decline in 2019, but Vigilance Is Needed as COVID-19 Raises New Concerns
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  • Medicare Laboratory Test Expenditures Increased in 2018, Despite New Rate Reductions
  • Medicare Home Health Agency Provider Compliance Audit: Condado Home Care Program, Inc.
  • Visionquest Industries, Inc.: Audit of Medicare Payments for Orthotic Braces
  • Desoto Home Health Care, Inc.: Audit of Medicare Payments for Orthotic Braces
  • Inadequate Edits and Oversight Caused Medicare To Overpay More Than $267 Million for Hospital Inpatient Claims With Post-Acute-Care Transfers to Home Health Services
  • North Carolina Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse and Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Timely
  • The New York State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries Deaths
  • On-Site Psychological Services, P.C.: Audit of Medicare Payments for Psychotherapy Services
  • Alaska Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs
  • CMS Could Have Saved $192 Million by Targeting Home Health Claims for Review With Visits Slightly Above the Threshold That Triggers a Higher Medicare Payment
  • Advisory Opinion 20-04
  • CMS Did Not Administer and Manage Strategic Communications Services Contracts in Accordance With Federal Requirements
  • Hospitals Overbilled Medicare $1 Billion by Incorrectly Assigning Severe Malnutrition Diagnosis Codes to Inpatient Hospital Claims
  • Medicaid Data Can Be Used To Identify Instances of Potential Child Abuse or Neglect
  • Texas Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities
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