Reports

• U.S. Department of Health and Human Services Met the Requirements of the Digital Accountability and Transparency Act of 2014, With Areas That Require Improvement

  

• Texas Claimed or May Have Claimed More Than $30 Million of $9.89 Billion in Federal Funds for Medicaid Uncompensated Care Payments That Did Not Meet Federal and State Requirements

  

• Advisory Opinion 22-19

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HumanaChoice (Contract R5826) Submitted to CMS

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Highmark Senior Health Company 

  

• UPICs Hold Promise To Enhance Program Integrity Across Medicare and Medicaid, But Challenges Remain

  

• Medicare Advantage Compliance Audit of Diagnosis Codes That Inter Valley Health Plan, Inc.

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That BlueCross BlueShield of Tennessee, Inc. (Contract H7917) Submitted to CMS

  

• Medicare Dialysis Services Provider Compliance Audit - Dialysis Clinic, Inc.

  

• Medicare Hospice Provider Compliance Audit: Hospice of Palm Beach County, Inc.

• End-Stage Renal Disease Network Organizations Reported Actions Taken in Response to the COVID-19 Pandemic

  

• CMS System Edits Significantly Reduced Improper Payments to Acute-Care Hospitals After May 2019 for Outpatient Services Provided to Beneficiaries Who Were Inpatients of Other Facilities

  

• CMS Has Opportunities To Strengthen States Oversight of Medicaid Managed Care Plans Reporting of Medical Loss Ratios

  

• FDA Repeatedly Adapted Emergency Use Authorization Policies To Address the Need for COVID-19 Testing

  

• FDA Work with the Tri-Agency Task Force for Emergency Diagnostics Helped Labs Implement COVID-19 Tests

  

• Nearly All States Made Capitation Payments for Beneficiaries Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Two States

  

• Medicare Part B Overpaid and Beneficiaries Incurred Cost-Share Overcharges of Over $1 Million for the Same Professional Services

  

• IHS National Supply Service Center Was Generally Effective in Providing Supplies to Facilities During the COVID-19 Pandemic, but Its Internal Controls Could Be Improved

  

• Advisory Opinion 22-18

  

• Opioid Overdoses and the Limited Treatment of Opioid Use Disorder Continue To Be Concerns for Medicare Beneficiaries