Reports

• Illinois Medicaid Managed Care Organizations Received Capitation Payments After Beneficiaries Deaths

  

• Mederi Caretenders Home Health Billed for Home Health Services That Did Not Comply With Medicare Billing Requirements

  

• National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded in 2017 and 2018

  

• Review of Medicare Administrative Contractor Information Security Program Evaluations for Fiscal Year 2018

  

• Medicare Part D Is Still Paying Millions for Drugs Already Paid for Under the Part A Hospice Benefit

  

• New York Incorrectly Claimed Enhanced Federal Medicaid Reimbursement for Some Beneficiaries

  

• Pennsylvania Did Not Ensure That Its Managed-Care Organizations Complied With Requirements Prohibiting Medicaid Payments for Services Related to Provider-Preventable Conditions

  

• Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2017 Average Sales Prices

  

• Group Health Incorporated Understated Its EmblemHealth Services Company, LLC, Employees Retirement Plan Medicare Segment Pension Assets as of January 1, 2015

  

• Group Health Incorporated Overstated Its Local 153 Pension Plan Medicare Segment Pension Assets as of January 1, 2015

  

• Group Health Incorporated Understated Its Cash Balance Pension Plan Medicare Segment Pension Assets as of January 1, 2011

  

• ACOs Strategies for Transitioning to Value-Based Care: Lessons From the Medicare Shared Savings Program

  

• Case Study: Indian Health Service Management of Rosebud Hospital Emergency Department Closure and Reopening

  

• New York Did Not Correctly Determine Medicaid Eligibility for Some Non-Newly Eligible Beneficiaries

  

• Kentucky Did Not Comply With Federal Waiver and State Requirements at 14 of 20 Adult Day Health Care Facilities Reviewed

  

• Problems Remain for Ensuring That All High Risk Medicaid Providers Undergo Criminal Background Checks

  

• Opioid Use Decreased in Medicare Part D, While Medication-Assisted Treatment Increased

  

• New Yorks Claims for Medicaid Nursing Home Transition and Diversion Waiver Program Services Generally Complied With Federal and State Requirements but Had Reimbursement Errors That Resulted in a Minimal Amount of Overpayments

  

• New York Claimed Federal Reimbursement for Some Payments to Health Home Providers That Did Not Meet Medicaid Requirements

  

• Hospice Deficiencies Pose Risks to Medicare Beneficiaries