Reports

• 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

  

• The District of Columbia Has Taken Significant Steps To Ensure Accountability Over Amounts Managed Care Organizations Paid to Pharmacy Benefit Managers

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Geisinger Health Plan (Contract H3954) Submitted to CMS

  

• Georgia Did Not Always Invoice Rebates to Manufacturers for Pharmacy and Physician-Administered Drugs

  

• Some Skin Substitute Manufacturers Did Not Comply with New ASP Reporting Requirements