Reports

• Maine Did Not Always Invoice Rebates to Manufacturers for Physician-Administered Drugs

  

• Some Manufacturers Reported Inaccurate Drug Product Data to CMS

  

• Billions in Estimated Medicare Advantage Payments From Diagnoses Reported Only on Health Risk Assessments Raise Concerns

  

• Audit of Medicare Part D Pharmacy Fees: Horizon Blue Cross Blue Shield, Inc.

  

• Colorado Claimed Unsupported and Incorrect Federal Medicaid Reimbursement for Beneficiaries Enrolled in the New Adult Group

  

• Medicare Hospital Provider Compliance Audit: Flagstaff Medical Center

  

• Tribal Health Programs: Concerns About Background Verifications for Staff Working With Indian Children

  

• CMS Generally Met Requirements for the DMEPOS Competitive Bidding Program Round 1 Recompete

  

• Indiana Monitoring Did Not Ensure Child Care Provider Compliance With State Criminal Background Check Requirements at 17 of 30 Providers Reviewed

  

• Michigan Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations

  

• Illinois Claimed Unallowable Telemedicine Payments

  

• Indiana Paid $3.5 Million for Medicaid Nonemergency Medical Transport Claims That Did Not Comply With Federal and State Requirements

  

• Foreign Assistance to Combat HIV/AIDS, Tuberculosis, and Malaria Fiscal Year 2021 Inspectors General Coordinated PEPFAR Oversight Plan U.S. Department of Health and Human Services, Office of Inspector General

  

• Texas Relied on Impermissible Provider-Related Donations To Fund the State Share of the Medicaid Delivery System Reform Incentive Payment Program

  

• Medicare Contractors Were Not Consistent in How They Reviewed Extrapolated Overpayments in the Provider Appeals Process

  

• CMS Encounter Data Lack Essential Information That Medicare Advantage Organizations Have the Ability to Collect

  

• Indiana Properly Reported Adjustments Related to the Drug Rebate Program

  

• Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2018 Average Sales Prices.

  

• Medicare Home Health Agency Provider Compliance Audit: Mission Home Health of San Diego, Inc.

  

• Opioid Use in Medicare Part D Continued To Decline in 2019, but Vigilance Is Needed as COVID-19 Raises New Concerns