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CMS Use of Staffing Data To Inform State Oversight of Nursing Homes

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health and Life Insurance Company (Contract H1608) Submitted to CMS

Medicare Payments for Evaluation and Management Services Provided on the Same Day as Eye Injections Were at Risk for Noncompliance With Medicare Requirements

Maryland Did Not Comply With Federal Waiver and State Requirements at 20 Adult Day Care Facilities Audited

CMS Is Not Systematically Tracking Whether States Return Federal Shares of Medicaid Managed Care Remittances

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

Most Medicare Part D Plans’ Formularies Included Humira Biosimilars for 2025

Ohio Did Not Comply With Federal Waiver and State Requirements at 18 of 19 Adult Day Care Facilities Audited

Fewer than One in Five Medicare Enrollees Received Medication to Treat Their Opioid Use Disorder

Medicare Administrative Contractors Did Not Consistently Meet Medicare Cost Report Oversight Requirements

State Survey Agencies Need Additional Guidance to Assess Nursing Home Emergency Preparedness Programs

Texas Did Not Fully Comply With Federal Waiver and State Health, Safety, and Administrative Requirements at All 20 Adult Day Activity Health and Service Facilities Audited

North Carolina’s Medicaid Control Environment, Risk Management Practices, and Governing Processes Were Assessed as Moderate Risk

Office of Inspector General’s Partnership With the Commonwealth of Massachusetts, Office of the State Auditor: Office of Medicaid (MassHealth) – Review of Capitation Payments With Multiple Identification Numbers

Medicare and Medicaid Payments to Providers Are at Risk of Diversion Through Electronic Funds Transfer Fraud Schemes

Medicare Part D Spending for 10 Selected Diabetes Drugs Totaled $35.8 Billion in 2023, an Increase of 364 Percent From 2019

Office of Inspector General’s Partnership With the Office of the Washington State Auditor: State Auditor’s Report Examining Washington’s Concurrent Medicaid Enrollments

Medicare Contractors Did Not Use Complete and Timely Utilization Data When Making Part B Coverage Determinations for Stelara

Mental Health Center of Florida Generally Met Medicare Billing Requirements for Some Psychotherapy Services

Medicare Paid Claims That Were Not in Accordance With the Over-the- Counter COVID-19 Test Kits Demonstration Quantity Limitation

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