Reports

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HealthAssurance, Pennsylvania, Inc. (Contract R5826) Submitted to CMS

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Humana Health Plan, Inc. (Contract H2649) Submitted to CMS

  

• CMS Recovered Medicare Payments to Providers Under the COVID-19 Accelerated and Advance Payments Program in Compliance With Federal Requirements

  

• Medicare and Medicaid Enrollees in Many High-Need Areas May Lack Access to Medications for Opioid Use Disorder

  

• Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2022 Average Sales Prices

  

• Novitas Solutions, Inc., Reopened and Corrected Cost Report Final Settlements With Obvious Errors To Collect Overpayments Made to Medicare Providers

  

• New Mexico Did Not Ensure Attendants Were Qualified To Provide Personal Care Services, Putting Medicaid Enrollees at Risk

  

• Massachusetts Opioid Treatment Program Services Met Many of the Federal and State Requirements 

  

• South Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations

  

• Utah Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements

  

• Kansas’s Implemented Electronic Visit Verification System Could Be Improved

  

• Certain For-Profit Nursing Homes May Not Have Complied With Federal Requirements Regarding the Infection Preventionist Position

  

• Illinois MMIS and E&E System Had Adequate Security Controls in Place, but Some Improvements Are Needed

  

• Massachusetts Generally Completed Medicaid Eligibility Actions During the Unwinding Period in Accordance With Federal and State Requirements

  

• Medicare Advantage Compliance Audit of Diagnosis Codes That MMM Healthcare, LLC, (Contract H4003) Submitted to CMS

  

• Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2024

  

• Office of Inspector General’s Partnership With the Ohio Auditor of State: Auditor of State’s Report Ohio Department of Medicaid: The Cost of Concurrent Enrollment

  

• Medicare Improperly Paid Hospitals an Estimated $79 Million for Enrollees Who Had Received Mechanical Ventilation

  

• Medicare and Some Enrollees Paid Substantially More When Stelara Was Covered Under Part D Versus Part B

  

• Opioid Treatment Programs in Washington State Did Not Fully Comply With Federal and State Requirements, Which May Have Put Medicaid Enrollees at Risk for Poor Treatment Outcomes