Reports

• New Mexico Did Not Claim $12.4 Million of $222.6 Million in Medicaid Payments for Services Provided by Indian Health Service Facilities in Accordance With Federal and State Requirements

  

• Telehealth Was Critical for Providing Services to Medicare Beneficiaries During the First Year of the COVID-19 Pandemic

  

• Advisory Opinion 22-05

  

• New York Verified That Medicaid Assisted Living Program Providers Met Life Safety and Emergency Planning Requirements But Did Not Always Ensure That Assisted Living Program Services Met Federal and State Requirements

  

• New Jersey Medicaid School-Based Cost Settlement Process Could Result in Claims That Do Not Meet Federal Requirements

  

• The Centers for Medicare & Medicaid Services Eligibility Review Contractor Adequately Determined Medicaid Eligibility for Selected States Under the Payment Error Rate Measurement Program

  

• Advisory Opinion 22-04

  

• Hospitals Did Not Always Meet Differing Medicare Contractor Specifications for Bariatric Surgery

• Office of Inspector General Partnership With the Oregon Secretary of State Audits Division: Oregon Health Authority-Timely Notification of Inpatient Hospital Stays Could Help Reduce Improper Medicaid Payments

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Tufts Health Plan (Contract H2256) Submitted to CMS

  

• Medicare Payments of $6.6 Billion to Nonhospice Providers Over 10 Years for Items and Services Provided to Hospice Beneficiaries Suggest the Need for Increased Oversight

  

• Advisory Opinion 22-03

  

• Advisory Opinion 22-02

  

• Medicare Advantage Compliance Audit of Diagnosis Codes That SCAN Health Plan (Contract H5425) Submitted to CMS

  

• Prior Audits of Medicaid Eligibility Determinations in Four States Identified Millions of Beneficiaries Who Did Not or May Not Have Met Eligibility Requirements

  

• The Assistant Secretary for Administration Awarded and Managed Five Sole Source Contracts for COVID-19 Testing in Accordance With Federal and Contract Requirements

  

• Advisory Opinion 22-01

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Healthfirst Health Plan, Inc., (Contract H3359) Submitted to CMS

  

• Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Pension Assets and Understated Medicare Share of the Medicare Segment Excess Pension Assets as of December 31, 2016

  

• Noridian Healthcare Solutions, LLC, Did Not Claim Some Allowable Medicare Pension Costs for Calendar Years 2014 Through 2016