Reports

• Data on Medicaid Managed Care Payments to Providers Are Incomplete and Inaccurate

  

• Companion Data Services, LLC, Properly Updated Its Excess Plan Medicare Segment Pension Assets as of January 1, 2017

  

• Advisory Opinion 21-01

  

• Hospitals Reported That the COVID-19 Pandemic Has Significantly Strained Health Care Delivery

  

• North Mississippi Medical Center: Audit of Medicare Payments for Polysomnography Services

  

• CMS Use of Data on Nursing Home Staffing: Progress and Opportunities To Do More

  

• Peninsula Regional Medical Center: Audit of Medicare Payments for Polysomnography Services

  

• Florida Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Assess, Prioritize, or Investigate Reported Incidents

  

• CMS Authorized Hundreds of Millions of Dollars in Advanced Premium Tax Credits on Behalf of Enrollees Who Did Not Make Their Required Premium Payments

  

• Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Blue Cross Blue Shield of Michigan (Contract H9572) Submitted to CMS

  

• Medicare Hospice Provider Compliance Audit: Tidewell Hospice, Inc.

  

• Trend Toward More Expensive Inpatient Hospital Stays in Medicare Emerged Before COVID-19 and Warrants Further Scrutiny

  

• Noridian Healthcare Solutions, LLC, Made Improper Medicare Payments of $4 Million to Physicians in Jurisdiction E for Spinal Facet-Joint Injections

  

• Iowa Should Improve Its Oversight of Selected Nursing Homes Compliance With Federal Requirements for Life Safety and Emergency Preparedness

  

• New York Did Not Fully Comply With Federal and State Requirements for Reporting and Monitoring Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities

  

• Illinois Made Capitation Payments to Managed Care Organizations for Medicaid Beneficiaries With Concurrent Eligibility in Another State

  

• Opioid Use in Medicare Part D During the Onset of the COVID-19 Pandemic

  

• Louisiana Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries

  

• California Claimed at Least $2 Million in Unallowable Medicaid Reimbursement for a Selected Providers Opioid Treatment Program Services

  

• Massachusetts Made at Least $14 Million in Improper Medicaid Payments for the Nonemergency Medical Transportation Program