Reports

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• Medicare Laboratory Test Expenditures Increased in 2018, Despite New Rate Reductions

  

• Medicare Home Health Agency Provider Compliance Audit: Condado Home Care Program, Inc.

  

• Visionquest Industries, Inc.: Audit of Medicare Payments for Orthotic Braces

  

• Desoto Home Health Care, Inc.: Audit of Medicare Payments for Orthotic Braces

  

• Inadequate Edits and Oversight Caused Medicare To Overpay More Than $267 Million for Hospital Inpatient Claims With Post-Acute-Care Transfers to Home Health Services

  

• North Carolina Did Not Ensure That Nursing Facilities Always Reported Allegations of Potential Abuse and Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Timely

  

• The New York State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries Deaths

  

• On-Site Psychological Services, P.C.: Audit of Medicare Payments for Psychotherapy Services

  

• Alaska Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs

  

• CMS Could Have Saved $192 Million by Targeting Home Health Claims for Review With Visits Slightly Above the Threshold That Triggers a Higher Medicare Payment

  

• Advisory Opinion 20-04

  

• CMS Did Not Administer and Manage Strategic Communications Services Contracts in Accordance With Federal Requirements

  

• Hospitals Overbilled Medicare $1 Billion by Incorrectly Assigning Severe Malnutrition Diagnosis Codes to Inpatient Hospital Claims

  

• Medicaid Data Can Be Used To Identify Instances of Potential Child Abuse or Neglect

  

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

  

• Advisory Opinion 20-03

  

• Part D Plans Generally Include Drugs Commonly Used by Dual Eligibles: 2020

  

• Unaccompanied Alien Children Program Care Provider Facilities Do Not Include All Required Security Measures in Their Checklists

  

• Texas Telemedicine Services Were Provided in Accordance with State Requirements