Reports

• Vulnerabilities Remain in Medicare Hospital Outlier Payments

  

• Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities

  

• Alabama Did Not Adequately Secure Its Medicaid Data and Information Systems

  

• Wisconsin Did Not Always Comply With Maternal, Infant, and Early Childhood Home Visiting Program Requirements

  

• Blue Cross Blue Shield Association Generally Claimed Allowable Medicare Postretirement Benefit Costs

  

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

  

• Drug Supply Chain Security: Wholesalers Exchange Most Tracing Information

  

• Arkansas Did Not Make Supplemental Payments in Accordance With Federal Requirements

  

• New York State Improperly Claimed Medicaid Reimbursement for Some Managed Long-Term Care Payments

  

• CMS Oversight Must Continue Because All Remaining Consumer Operated and Oriented Plans Were Not Profitable and May Not Be Viable and Sustainable

  

• Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets

  

• Kansas Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid

  

• Blue Cross Blue Shield of South Carolina Overstated Its Allocable Qualified Pension Plan Costs

  

• Challenges Appear to Limit States Use of Medicaid Payment Suspensions

  

• CMS and Its Claims Processing Contractors Issued Conflicting Guidance on the Proper Use of the KX Modifier for Part B Immunosuppressive Drug Claims

  

• Advisory Opinion 17-05

  

• Medicare Part B Drug Payments: Impact of Price Substitutions Based on 2014 Average Sales Prices

  

• Calculation of Potential Inflation-Indexed Rebates For Medicare Part B Drugs 2017

  

• Advisory Opinion 17-04

  

• As Funding for BPA Research Increased, NIEHS Followed Its Peer Review Process While Also Exercising Its Discretion