Reports

• 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

  

• Medicare Home Health Agency Provider Compliance Audit: Southeastern Home Health Services

  

• Independent Attestation Review: Centers for Disease Control and Prevention Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions

  

• Independent Attestation Review: Health Resources and Services Administration Fiscal Year 2020 Detailed Accounting Report, Performance Summary Report for National Drug Control Activities, Budget Formulation Compliance Report, and Accompanying Required Assertions

  

• Ohio Made Progress Toward Achieving Program Goals for Enhancing Its Prescription Drug Monitoring Program

  

• The Centers for Medicare & Medicaid Services Could Improve Its Wage Index Adjustment for Hospitals in Areas With the Lowest Wages

  

• Medicare Home Health Agency Provider Compliance Audit: Tender Touch Health Care Services

  

• Medicare Hospice Provider Compliance Audit: Hospice Compassus, Inc., of Tullahoma, Tennessee

  

• Advisory Opinion 20-05