Reports

• Department of Health and Human Services Met Many Requirements, but It Did Not Fully Comply With the Payment Integrity Information Act of 2019 and Applicable Improper Payment Guidance for the Fiscal Year 2022

  

• Montana Generally Complied With Requirements for Telehealth Services During the COVID-19 Pandemic

  

• Residents at Risk: The Strained Nursing Home Inspection System and the Need to Improve Oversight, Transparency, and Accountability

  

• The Risk of Misuse and Diversion of Buprenorphine for Opioid Use Disorder Appears to Be Low in Medicare Part D

  

• Examining Health Care Denials and Delays in Medicare Advantage

  

• Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the Fourth Quarter of 2022

  

• Review of the Department of Health and Human Services Compliance with the Federal Information Security Modernization Act of 2014 for Fiscal Year 2022

  

• Medicare Improperly Paid Providers for Some Psychotherapy Services, Including Those Provided via Telehealth, During the First Year of the COVID-19 Public Health Emergency

  

• Medicare Could Have Saved Up To $128 Million Over 5 Years if CMS Had Implemented Controls To Address Duplicate Payments for Services Provided to Individuals With Medicare and Veterans Health Administration Benefits

  

• Toolkit: Analyzing Telehealth Claims to Assess Program Integrity Risks

  

• Modification of Advisory Opinion 20-04

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HumanaChoice (Contract H6609) Submitted to CMS

  

• Testimony of Christi A. Grimm

  

• CMS Did Not Accurately Report on Care Compare One or More Deficiencies Related to Health, Fire Safety, and Emergency Preparedness for an Estimated Two-Thirds of Nursing Homes

  

• Texas Could Not Support the Permissibility of the Funds Used as the State Share of the Medicaid Delivery System Reform Incentive Payment Program

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Cigna-HealthSpring Life & Health Insurance Company, Inc. (Contract H4513) Submitted to CMS

  

• Advisory Opinion 23-03

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That MCS Advantage, Inc. (Contract H5577) Submitted to CMS

  

• Maryland Child Support Administration Generally Claimed Administrative Costs That Were Allowable and Allocable

  

• Medicare Improperly Paid Physicians an Estimated $30 Million for Spinal Facet-Joint Interventions