Reports

• DRG 87: Pulmonary Edema and Respiratory Failure

  

• National DRG Validation Study: Quality of Patient Care in Hospitals 

  

• Meritus Medical Center Refunded Overpayments for Physician Claims With Place-of-Service Coding Errors For 2009 Through 2012

  

• DRG 79: Respiratory Infection 

  

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

  

• DRG 468: Unrelated Operating Room Procedures

  

• Missouri Claimed Unallowable Medicaid Payments for Individuals With Intellectual and Developmental Disabilities in Intermediate Care Facilities

  

• FY 1985 National DRG Validation Study: Peer Review Organization Coding Accuracy

  

• DRG 14 Validation Update: Specific Cerebrovascular Disorders Except Transient Ischemic Attacks

  

• The New York State Manufacturer Rebate Program Significantly Reduced Medicaid Costs for Home Blood-Glucose Test Strips But Could Achieve Additional Reductions

  

• CGS Administrators, LLC, Paid Unallowable Lower Limb Prosthetics Claims

  

• National Government Services Claimed Allowable Administrative Costs for Fiscal Years 2008 and 2009 under Medicare Contract 00130

  

• New Jersey Did Not Always Claim Medicaid Reimbursement for Medicare Part B Premiums in Accordance with Federal Requirements

  

• Palmetto GBA Claimed Substantially Allowable Costs on Its Part B Final Administrative Cost Proposals for Fiscal Years 2010 and 2011

  

• Washington State Claimed a Small Amount of Unallowable Medicaid Reimbursement for Home Health Services That Exceeded the Maximum Allowable Number of Reimbursable Visits

  

• National DRG Validation Study Update: Technical Report

  

• Durable Medical Equipment Claims Paid by National Heritage Insurance Company, Inc., Did Not Always Meet the Requirements of the Local Coverage Determination for Lower Limb Prostheses

  

• Durable Medical Equipment Claims Paid by Noridian Healthcare Solutions, LLC, Did Not Always Meet the Requirements of the Local Coverage Determination for Lower Limb Prostheses

  

• Salary and Nonsalary Costs Claimed by the University of Texas Southwestern Medical Center Were Allowable

  

• Maryland Claimed Costs for Unallowable Room and Board and Other Residential Habilitation Costs Under Its Community Pathways Waiver Program