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All Reports and Publications

All Reports and Publications

Medicare Advantage: Questionable Use of Health Risk Assessments Continues To Drive Up Payments to Plans by Billions

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That HealthAssurance, Pennsylvania, Inc. (Contract H5522) Submitted to CMS

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Humana Health Plan, Inc. (Contract H2649) Submitted to CMS

Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2022 Average Sales Prices

Novitas Solutions, Inc., Reopened and Corrected Cost Report Final Settlements With Obvious Errors To Collect Overpayments Made to Medicare Providers

Most Children in Foster Care Did Not Receive Credit Checks and Assistance

South Carolina Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations

Medicare Improperly Paid Hospitals an Estimated $79 Million for Enrollees Who Had Received Mechanical Ventilation

Comparison of Average Sales Prices and Average Manufacturer Prices: Results for the First Quarter of 2024

Medicare and Some Enrollees Paid Substantially More When Stelara Was Covered Under Part D Versus Part B

Alaska Medicaid Fraud Control Unit: 2023 Inspection

Heluna Health May Not Have Used California’s CDC COVID-19 Funds in Accordance With Award Requirements

California Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State

West Virginia Medicaid Fraud Control Unit: 2023 Inspection

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Independent Health Association, Inc. (Contract H3362) Submitted to CMS

The National Institutes of Health Has Made Progress But Could Further Improve Its Closeout Process for Grants and Similar Awards

North Carolina Did Not Report and Return All Medicaid Overpayments for the State’s Medicaid Fraud Control Unit Cases

NIH Did Not Close Contracts in Accordance With Federal Requirements, Resulting in the Increased Risk of Fraud, Waste, and Abuse

CMS Could Strengthen Program Safeguards To Prevent and Detect Improper Medicare Payments for Short Inpatient Stays

Washington Medicaid Fraud Control Unit: 2023 Inspection

All Reports and Publications

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