Reports

• Advisory Opinion 21-15

  

• The District of Columbia Monitoring Did Not Ensure Child Care Provider Compliance With Criminal Background Check Requirements at 7 of 30 Providers Reviewed

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UPMC Health Plan, Inc. (Contract H3907) Submitted to CMS

  

• Michigan Did Not Report Calendar Year 2019 Medicaid Third-Party Liability Cost Avoidance Data to the Centers for Medicare & Medicaid Services

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health Care of Missouri, Inc. (Contract H2663) Submitted to CMS

  

• Office of Inspector General Partnership With the Commonwealth of Massachusetts Office of the State Auditor: Office of Medicaid (MassHealth) - Payments for Hospice-Related Services for Dual-Eligible Members

  

• Tennessee Medicaid Claimed Hundreds of Millions of Federal Funds for Certified Public Expenditures That Were Not in Compliance With Federal Requirements

  

• More Than One-Third of Medicaid-Enrolled Children in Five States Did Not Receive Required Blood Lead Screening Tests

  

• Most Medicare beneficiaries received telehealth services only from providers with whom they had an established relationship

  

• Changes Made to States Medicaid Programs To Ensure Beneficiary Access to Prescriptions During the COVID-19 Pandemic

  

• Minnesota Medicaid Managed Care Entities Used a Majority of Medicaid Funds Received for Medical Expenses and Quality Improvement Activities

  

• Medicare Overpaid $636 Million for Neurostimulator Implantation Surgeries

  

• Advisory Opinion 21-14

  

• Advisory Opinion 21-13

  

• High-expenditure Medicare drugs often qualified for Orphan Drug Act incentives designed to encourage the development of treatments for rare diseases

  

• Advisory Opinion 21-12

  

• An Ophthalmology Clinic in Florida: Audit of Medicare Payments for Eye Injections of Avastin, Eylea, and Lucentis

  

• Colorado Did Not Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations

  

• CMS COVID-19 Data Included Required Information From the Vast Majority of Nursing Homes, but CMS Could Take Actions To Improve Completeness and Accuracy of the Data

  

• Medicare Beneficiaries Hospitalized With COVID-19 Experienced a Wide Range of Serious, Complex Conditions