Reports

• National DRG Validation Study: Unnecessary Admissions to Hospitals 

  

• The New Jersey Department of Human Services Claimed Medicaid Disproportionate Share Hospital Payments to Five Hospitals That Did Not Meet Federal Eligibility Requirements

  

• New York Improperly Claimed Medicaid Reimbursement for Some Home Health Services Claims Submitted by Certified Home Health Agencies in New York City

  

• Massachusetts Generally Implemented Recommendations From Prior Review of Claims for Hospital Outpatient Clinical Laboratory Services

  

• Pennsylvania Claimed Unallowable Medicaid Administrative Costs for the Regional Housing Coordinator Initiative

  

• The Chicago Regional Council of Carpenters Welfare Fund Properly Claimed Early Retiree Reinsurance Program Reimbursements

  

• The UAW Retiree Medical Benefits Trust Properly Claimed Early Retiree Reinsurance Program Reimbursements

  

• California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Services Provided in San Diego County

  

• Lower Limb Prosthetics Claims Paid to Premier Prosthetics and Orthotics Were Not Always Supported by Adequate Documentation

  

• TrailBlazer Claimed Medicare Part B Administrative Costs in Accordance With Federal Requirements

  

• Neighborhood Diabetes, Inc., Submitted Claims for Diabetic Testing Supplies Without the KL Modifier in Accordance With Medicare Billing Requirements

  

• Arkansas Generally Supported Its Claim for Federal Medicaid Reimbursement

  

• Arizona Improperly Claimed Federal Reimbursement for Medicaid School-Based Administrative Costs

  

• Blue Cross Blue Shield of Tennessee Overclaimed Postretirement Benefit Costs for Fiscal Years 1992 Through 2009

  

• TrailBlazer Mostly Claimed Medicare Part A Administrative Costs in Accordance With Federal Requirements

  

• Indiana Improperly Claimed Federal Reimbursement for All Reviewed Medicaid Inpatient Psychiatric Hospital Service Payments to Logansport State Hospital

  

• Postretirement Benefit Costs Claimed by United Government Services for October 1, 2001, Through December 31, 2006, Were Reasonable and Allowable

  

• Blue Cross Blue Shield Association Did Not Claim Some Allowable Pension Costs For Fiscal Years 1997 Through 2010

  

• Missouri Claimed Federal Reimbursement for Unallowable Personal Care Services Claims Submitted by The Whole Person, Incorporated

  

• Florida Claimed Some Medicaid Administrative Costs That Did Not Comply With Program Requirements