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Centers for Medicare and Medicaid Services (CMS)

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CMS Document Archive

2017

09-18-2017: Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities (A-09-16-02026)
09-14-2017: Vulnerabilities Remain in Medicare Hospital Outlier Payments (A-07-14-02800); Blue Cross Blue Shield Association Generally Claimed Allowable Medicare Postretirement Benefit Costs (A-07-17-00521)
09-12-2017: Nevada Did Not Bill Manufacturers for Some Rebates for Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-16-02027); Sierra Nevada Memorial Hospital Did Not Accurately Report Certain Wage Data, Resulting in Overpayments to California Hospitals (A-09-16-02044)
09-11-2017: Arkansas Did Not Make Supplemental Payments in Accordance With Federal Requirements (A-06-15-00042); New York State Improperly Claimed Medicaid Reimbursement for Some Managed Long-Term Care Payments (A-02-15-01026)
09-08-2017: Alabama Did Not Adequately Secure Its Medicaid Data and Information Systems (A-04-15-05065)
09-06-2017: Kansas Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-07-17-03218)
08-28-2017: Companion Data Services, LLC, Understated Its Allocable Pension Costs (A-07-17-00511); Companion Data Services, LLC, Overstated Its Medicare Segment Pension Assets (A-07-17-00512); Blue Cross Blue Shield of South Carolina Overstated Its Allocable Qualified Pension Plan Costs (A-07-17-00509)
08-25-2017: CMS Oversight Must Continue Because All Remaining Consumer Operated and Oriented Plans Were Not Profitable and May Not Be Viable and Sustainable (A-05-16-00027); CMS and Its Claims Processing Contractors Issued Conflicting Guidance on the Proper Use of the KX Modifier for Part B Immunosuppressive Drug Claims (A-06-15-00018)
08-24-2017: Early Alert: The Centers for Medicare & Medicaid Services Has Inadequate Procedures To Ensure That Incidents of Potential Abuse or Neglect at Skilled Nursing Facilities Are Identified and Reported in Accordance With Applicable Requirements (A-01-17-00504)
08-23-2017: Fox Rehabilitation Claimed Unallowable Medicare Reimbursement for Outpatient Therapy Services (A-02-16-01004); Accredo Health Group, Inc., Properly Billed Medicare for Inhalation Drugs (A-09-16-02022)
08-18-2017: Medicare Compliance Review of Parkridge Medical Center, Inc., for 2014 and 2015 (A-04-16-08048)
08-17-2017: Kentucky Did Not Always Perform Medicaid Eligibility Determinations for Non-Newly Eligible Beneficiaries in Accordance With Federal and State Requirements (A-04-16-08047)
08-16-2017: Public Summary Report: The State of North Carolina Did Not Ensure That Federal Information System Security Requirements Were Met for Safeguarding Its Medicaid Claims Processing Systems and Data (A-07-16-00469)
08-14-2017: Texas Improperly Received Medicaid Reimbursement for School-Based Health Services (A-06-14-00002)
08-10-2017: TrailBlazer Health Enterprises, LLC, Claimed Some Unallowable Medicare Administrative Contract Pension Costs (A-07-17-00510)
08-09-2017: Public Summary Report: Information Technology Control Weaknesses Found in the New Mexico Human Services Department's Medicaid Eligibility Systems (A-06-16-05000); A Brooklyn Chiropractor Received Unallowable Medicare Payments for Chiropractic Services (A-02-13-01047); Maine Did Not Comply With Federal and State Requirements for Critical Incidents Involving Medicaid Beneficiaries With Developmental Disabilities (A-01-16-00001)
08-08-2017: TrailBlazer Health Enterprises, LLC, Understated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Assets (A-07-17-00507); TrailBlazer Health Enterprises, LLC, Did Not Claim Some Allowable Medicare Pension Costs (A-07-17-00508)
08-04-2017: Oklahoma Did Not Adequately Oversee Its Medicaid Nonemergency Medical Transportation Program (A-06-16-00007)
07-17-2017: Some Hospitals in Medicare Jurisdiction F Claimed Residents as More Than One Full-Time Equivalent (A-02-15-01028)
07-12-2017: Review of Pennsylvania Medicaid Managed Care Program Potential Savings With Minimum Medical Loss Ratio (A-03-15-00203)
07-10-2017: First Coast Service Options, Inc., Understated Its Medicare Segment and Overstated Its Other Segment Allocable Postretirement Benefit Costs (A-07-17-00502); First Coast Service Options, Inc., Did Not Claim Some Allowable Medicare Postretirement Benefit Costs (A-07-17-00500)
07-07-2017: Some Hospitals in Medicare Jurisdiction E Claimed Residents as More Than One Full-Time Equivalent (A-02-15-01027); First Coast Service Options, Inc., Overstated Its Medicare Segment Postretirement Benefit Assets (A-07-17-00499)
07-06-2017: Palmetto Government Benefits Administrator, LLC, Understated Its Medicare Segment Pension Assets (A-07-17-00503); Palmetto Government Benefits Administrator, LLC, Generally Claimed Allowable Medicare Pension Costs (A-07-17-00504); Palmetto Government Benefits Administrator, LLC, Understated Its Medicare Segment Allocable Pension Costs (A-07-17-00505)
06-28-2017: Medicare Paid New England Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays During Calendar Years 2013 and CY 2014 (A-01-15-00511)
06-20-2017: Wisconsin Physicians Service Insurance Corporation Did Not Properly Settle Missouri Medicare Disproportionate Share Hospital Payments (A-07-16-04229)
06-01-2017: Louisiana Complied With the Requirements of the Social Security Act in Its Review of Cases of Credible Allegations of Medicaid Fraud (A-06-16-00010)
06-07-2017: Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did Not Comply With Federal Requirements (A-05-14-00047)
06-06-2017: Review of Wisconsin Medicaid Managed Care Program Potential Savings With Minimum Medical Loss Ratio (A-05-15-00040)
06-01-2017: Louisiana Complied With the Requirements of the Social Security Act in Its Review of Cases of Credible Allegations of Medicaid Fraud (A-06-16-00010)
05-17-2017: Medicare Could Save Millions by Eliminating the Lump-Sum Purchase Option for All Power Mobility Devices (A-05-15-00020)
05-12-2017: Public Summary Report: Virginia Did Not Adequately Secure Its Medicaid Data (A-04-15-05066)
05-11-2017: Minnesota Disbursed Only Part of Its Civil Money Penalty Collections, Limiting Resources To Protect and Improve Care for Nursing Facility Residents (A-05-16-00017)
05-10-2017: Kentucky Did Not Correctly Determine Medicaid Eligibility for Some Newly Enrolled Beneficiaries (A-04-15-08044)
05-09-2017: U.S. Department of Health and Human Services Met Many Requirements of the Improper Payments Information Act of 2002 but Did Not Fully Comply for Fiscal Year 2016 (17-17-52000)
05-08-2017: Medical Ambulance Services, Inc., Claimed Unallowable Reimbursement for Medicare Part B Ambulance Services (A-02-15-01016); CGS Administrators, LLC, Generally Claimed Allowable Medicare Pension Costs (A-07-16-00489); CGS Administrators, LLC, Did Not Claim Some Allowable Medicare Administrative Contract Postretirement Benefit Costs (A-07-17-00498); CGS Administrators, LLC, Claimed Some Unallowable Medicare Administrative Contract Pension Costs (A-07-16-00490); Briefing to The Honorable Gus Bilirakis, Subcommittee on Health, Committee on Energy and Commerce, House of Representatives Audit Briefing (A-02-17-02001)
05-05-2017: A Missouri Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Physical Therapy Services (A-07-14-01147); Iowa Did Not Invoice Rebates to Manufacturers for Physician-Administered Drugs of Medicaid Managed-Care Organizations (A-07-16-06065)
05-02-2017: CGS Administrators, LLC, Overstated Its CIGNA Pension Plan Medicare Segment Pension Assets and Understated Medicare's Share of Excess Pension Liabilities (A-07-16-00470); CGS Administrators, LLC, Understated Its CIGNA Pension Plan for Certain Former Employees Medicare Segment Pension Assets and Understated Medicare's Share of Excess Pension Assets (A-07-16-00491)
04-24-2017: Medicare Compliance Review of Mount Sinai Hospital for 2012 and 2013 (A-02-14-01019)
04-20-2017: California Incorrectly Claimed Additional Medicaid Funding Authorized Under the Recovery Act When Reclaiming Overpayments Made to Bankrupt or Out-of-Business Providers (A-09-14-02030); Florida Did Not Suspend Medicaid Payments to Some Providers That Had Credible Fraud Allegation Cases in Accordance With the Social Security Act (A-04-14-07046)
04-19-2017: New Jersey Claimed Medicaid Reimbursement for Adult Partial Hospitalization Services That Did Not Comply With Federal and State Requirements (A-02-14-01015)
04-11-2017: Illinois Made Correct Medicaid Claim Adjustments (A-05-15-00031)
04-18-2017: Ohio's and Michigan's Sales and Use Taxes on Medicaid Managed Care Organization Services Do Not Meet Broad-Based Requirement (A-03-16-00200)
03-30-2017: Ohio Made Incorrect Medicaid Payments to Providers for Full Vials of Herceptin (A-05-15-00032)
03-23-2017: Wisconsin Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-05-16-00014)
03-22-2017: Medicare Compliance Review of the University of Arkansas for Medical Sciences Medical Center for 2013 and 2014 (A-06-16-00005)
03-17-2017: Missouri Properly Verified Correction of Deficiencies Identified During Surveys of Nursing Homes (A-07-16-03217)
03-15-2017: Mississippi Claimed Millions in Unallowable School-Based Medicaid Administrative Costs (A-04-15-00103)
03-14-2017: Alta Bates Medical Center Inaccurately Reported Wage Data, Resulting in Medicare Overpayments Audit (A-09-14-02035)
03-13-2017: Medicare Compliance Review of Jackson-Madison County General Hospital for Claims Paid From June 1, 2013, Through May 31, 2015 (A-04-15-04042); Nantucket Cottage Hospital Did Not Accurately Report Certain Wage Data, Resulting in Overpayments to Massachusetts Hospitals (A-01-15-00502)
03-09-2017: Public Summary Report: Information Technology Control Weaknesses Found at the Commonwealth of Massachusetts' Medicaid Management Information System (A-06-15-00057)
03-08-2017: Hospitals Nationwide Generally Did Not Comply With Medicare Requirements for Billing Outpatient Right Heart Catheterizations With Heart Biopsies (A-01-13-00511)
03-07-2017: Medicare Compliance Review of University of Florida Health Jacksonville for 2013 and 2014 (A-04-15-07057); Blue Cross Blue Shield Association Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2011 Through 2015 (A-07-17-00497); Blue Cross Blue Shield Association Overstated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Assets as of September 30, 2015 (A-07-17-00496)
03-03-2017: Medicare Compliance Review of Mayo Clinic Florida for 2013 and 2014 (A-04-15-07058)
03-02-2017: Review of Blue Cross Blue Shield Association Final Administrative Cost Proposals for Fiscal Years 2010 Through 2015 (A-05-15-00056)
03-01-2017: Texas Made Unallowable Medicaid Managed Care Payments for Beneficiaries Assigned More Than One Medicaid Identification Number (A-06-15-00024); Medicare Contractors' Payments to Providers for Hospital Outpatient Dental Services Generally Did Not Comply With Medicare Requirements (A-06-16-05003); Nebraska Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Transportation Program (A-07-16-03209); New York Improperly Claimed Federal Medicaid Reimbursement for Partial Hospitalization Services (A-02-16-01013)
02-02-2017: Kentucky Misallocated Millions to Establishment Grants for a Health Insurance Marketplace (A-04-14-07050)
01-31-2017: Vidant Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition (A-03-15-00011)
01-26-2017: New York Claimed Medicaid Reimbursement for Unallowable Dental Services Billed by a Dentist Based in Westchester County (A-02-13-01033); New York Claimed Medicaid Reimbursement for Unallowable Dental Services Billed by a Dentist Based in Queens (A-02-13-01034)
01-17-2017: Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2015 (A-18-16-30300)
01-13-2017: Review of California Medicaid Managed-Care Program Potential Savings With Minimum Medical Loss Ratio (A-09-15-02025)
01-05-2017: Colorado Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-07-14-06050)
01-04-2017: California Improperly Claimed Federal Medicaid Reimbursement for Certain Nonemergency Services (A-09-15-02020); Louisiana Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Program (A-06-15-00019)

2016

12-30-2016: Northside Medical Center Incorrectly Billed Medicare Inpatient Claims with Severe Malnutrition (A-03-15-00012); Delaware Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-03-15-00202)
12-27-2016: A Southern California Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Therapy Services (A-09-15-02015); New Jersey Claimed Medicaid Adult Mental Health Partial Care Services That Were Not in Compliance With Federal and State Requirements (A-02-13-01029); Colorado Did Not Correctly Expend Establishment Grant Funds for Establishing a Health Insurance Marketplace (A-07-14-02801)
12-22-2016: Medicare Compliance Review of NorthShore University HealthSystem for 2013 and 2014 (A-05-15-00044); Virginia Did Not Bill Manufacturers for Some Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-03-15-00201); Medicare Compliance Review of University of Mississippi Medical Center for 2013 and 2014 (A-04-15-00105)
12-21-2016: Review of South Carolina's Medicaid Managed Care Program Potential Savings With Minimum Medical Loss Ratio (A-04-16-06191)
12-19-2016: Medicare Compliance Review of North Mississippi Medical Center for 2013 and 2014 (A-04-15-00106)
12-14-2016: Medicare Compliance Review of Abbott Northwestern Hospital for 2013 and 2014 (A-05-15-00043)
12-08-2016: California Did Not Bill Manufacturers for Rebates for Physician-Administered Drugs Dispensed to Enrollees of Some Medicaid Managed-Care Organizations (A-09-15-02035)
11-30-2016: Audit of Medicaid Capitation Payments for Deceased Beneficiaries in Florida (A-04-15-06182); Review of Massachusetts Medicaid Managed Care Program Potential Savings with Minimum Medical Loss Ratio (A-01-15-00505)
11-23-2016: The Minnesota Marketplace Misallocated Federal Funds and Claimed Unallowable Costs (A-05-14-00045)
11-22-2016: Hospitals Did Not Always Comply With Medicare Requirements for Reporting Cochlear Devices Replaced Without Cost (A-01-15-00508)
11-21-2016: New York Misallocated Costs to Establishment Grants for a Health Insurance Marketplace (A-02-14-02017)
11-18-2016: North Carolina Improperly Claimed Federal Reimbursement for Some Medicaid Nonemergency Transportation Services (A-04-15-04037)
11-04-2016: Public Summary Report: New York Implemented Security Controls Over Its Health Insurance Exchange Web Site and Database but Could Improve Security Controls (A-02-15-03001)
11-01-2016: A Northern California Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Therapy Services (A-09-14-02040); TrustSolutions, LLC, Claimed Unallowable Medicare Pension Costs for 2007 Through 2009 (A-07-16-00487); Wisconsin Physicians Service Insurance Corporation Did Not Properly Settle Indiana Medicare Disproportionate Share Hospital Cost Report Payments (A-07-15-04219)
10-31-2016: Indiana Did Not Always Make Correct Medicaid Claim Adjustments (A-05-15-00022)
10-28-2016: New York Claimed Medicaid Reimbursement for Unallowable Dental Services Billed by a Dentist Based in New York City (A-02-13-01032)
10-27-2016: North Dakota Claimed Some Unallowable Medicaid Payments for Targeted Case Management Services (A-07-16-03210)
10-20-2016: Arizona Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-09-16-02013)
10-19-2016: Virginia Medicaid Electronic Health Record Payments (A-03-14-00404); State Agencies Claimed Unallowable and Unsupported Medicaid Reimbursements for Services Under the Home and Community-Based Services Waiver Program (A-07-16-03212)
10-18-2016: Hundreds of Millions in Medicare Payments for Chiropractic Services Did Not Comply With Medicare Requirements (A-09-14-02033)
10-17-2016: New York Made Some Incorrect Medicaid Electronic Health Record Incentive Payments (A-02-14-01020)
10-14-2016: Medicaid Enrollment Using the Express Lane Eligibility Option Did Not Always Meet Federal Requirements (A-04-15-08043); Children's Health Insurance Program Enrollment Using the Express Lane Eligibility Option Did Not Always Meet Federal Requirements (A-04-15-08045)
10-06-2016: North Carolina Claimed Millions in Unallowable School-Based Medicaid Administrative Costs (A-04-15-00101); Medicare's Policies and Procedures Identified Almost All Improper Claims Submitted for Deceased Individuals and Recouped Almost All Improper Payments Made for These Claims for January 2013 Through October 2015 (A-07-16-05089); Medicare Improperly Paid Providers Millions of Dollars for Incarcerated Beneficiaries Who Received Services During 2013 and 2014 (A-07-15-01158)
10-04-2016: Public Summary Report: The State of Colorado Did Not Meet Federal Information System Security Requirements for Safeguarding Its Medicaid Systems and Data (A-07-15-00463); Noridian Healthcare Solutions, LLC, Did Not Claim Allowable Medicare Pension Costs or Postretirement Benefit Costs for Fiscal Years 2006 Through 2008 (A-07-16-00481)
10-03-2016: Medicare Compliance Review of Bergan Mercy Medical Center for 2013 and 2014 (A-07-15-05084)
09-30-2016: Michigan Improperly Received Medicaid Reimbursement for School-Based Health Services (A-05-13-00056); Early Alert: Incorporating Medical Device-Specific Information on Claim Forms (A-01-16-00510)
09-27-2016: Sleep Health Center Billed Medicare for Some Unallowable Sleep Study Services (A-04-14-07053); Medicare Improperly Paid Millions of Dollars for Unlawfully Present Beneficiaries for 2013 and 2014 (A-07-15-01159)
09-26-2016: Virginia Did Not Always Make Correct Medicaid Claim Adjustments (A-03-14-00204); Public Summary Report: Information Technology Control Weaknesses Found at the Minnesota Health Insurance Exchange (A-06-15-00035); California Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals (A-09-16-02004)
09-23-2016: Vermont Did Not Properly Allocate Millions to Establishment Grants for a Health Insurance Marketplace (A-01-15-02500)
09-21-2016: Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs for Fiscal Years 2005 Through 2011 (A-07-16-00483); CGS Administrators, LLC's Postretirement Benefit Costs for Fiscal Year 2011 Were Reasonable and Allowable (A-07-16-00484); Blue Cross Blue Shield of South Carolina Overstated Its Allocable Medicare Postretirement Benefit Costs for Calendar Years 2006 Through 2011 (A-07-16-00485)
09-20-2016: Illinois Claimed Some Improper Federal Medicaid Reimbursement for Inpatient Hospital Services Related to Treating Provider-Preventable Conditions (A-05-15-00033); Washington State Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals (A-09-16-02015)
09-15-2016: Idaho Claimed Federal Medicaid Reimbursement for Inpatient Hospital Services Related to Treating Provider-Preventable Conditions (A-09-15-02013); Washington State Claimed Federal Medicaid Reimbursement for Inpatient Hospital Services Related to Treating Provider-Preventable Conditions (A-09-14-02012)
09-14-2016: Medicare Compliance Review of North Carolina Baptist Hospital for Claims Paid From January 1, 2013, Through August 31, 2014 A-04-15-04036)
09-12-2016: Ohio Did Not Always Make Correct Medicaid Claim Adjustments (A-05-14-00017)
08-30-2016: Ohio Made Incorrect Medicaid Electronic Health Record Incentive Payments (A-05-13-00043)
08-29-2016: Oklahoma Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals (A-06-15-00032)
08-25-2016: New Jersey Made Incorrect Medicaid Electronic Health Record Incentive Payments (A-02-14-01009)
08-22-2016: A Kansas Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Physical Therapy Services (A-07-14-01146)
08-18-2016: Kansas Correctly Invoiced Rebates to Manufacturers for Most Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-07-15-06060)
08-17-2016: Medicare Compliance Review of Home Health VNA for 2011 and 2012 (A-01-13-00518)
08-15-2016: State Governments May Unduly Benefit Financially From Publicly Owned but Privately Operated Entities (A-06-16-08005)
08-11-2016: Colorado Received Millions in Unallowable Bonus Payments (A-04-15-08039)
08-10-2016: West Virginia Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals (A-03-14-00406); Pennsylvania Made Correct Medicaid Electronic Health Record Incentive Payments to Hospitals (A-03-15-00403); Public Summary Report: Wireless Penetration Test of Centers for Medicare & Medicaid Services' Data Centers (A-18-15-30400)
08-08-2016: A Michigan Chiropractor Received Unallowable Medicare Payments for Chiropractic Services (A-07-14-01148); Texas Did Not Always Calculate Physician Supplemental Payments Made to the University of Texas Health Institutions in Accordance With Federal and State Requirements (A-06-11-00004)
08-04-2016: Medicare Compliance Review of New York-Presbyterian Hospital for 2011 and 2012 (A-02-13-01027); Conversions of Startup Loans Into Surplus Notes by Consumer Operated and Oriented Plans Were Allowable but Not Always Effective (A-05-16-00019); Arizona Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals (A-09-15-02036)
08-03-2016: Cornerstone Hospital of Austin Incorrectly Billed Medicare Inpatient Claims with Kwashiorkor (A-03-15-00009)
08-02-2016: Louisiana Made Incorrect Herceptin Payments to Medicaid Providers (A-06-15-00037)
08-01-2016: Texas Did Not Always Comply With Federal Requirements and Its Cost Allocation Plan When It Claimed Medicaid Administrative Costs (A-06-15-00038)
07-27-2016: New York Improperly Claimed Federal Medicaid Reimbursement for the Drug Herceptin Over a 3-Year Period (A-02-15-01013)
07-14-2016: First Coast Service Options, Inc., Did Not Claim Some Medicare Supplemental Executive Retirement Plan Costs for Fiscal Years 2006 Through 2009 (A-07-16-00472); Medicare Compliance Review of Excellent Home Care Services, LLC (A-02-14-01005)
07-13-2016: Massachusetts Did Not Comply With Federal and State Requirements for Critical Incidents Involving Developmentally Disabled Medicaid Beneficiaries (A-01-14-00008); Alabama Did Not Comply With Federal and State Requirements for Claiming Medicaid Certified Public Expenditures for Federal Fiscal Year 2010 (A-06-15-00004); Alabama Claimed Millions in Unallowable School-Based Medicaid Administrative Costs (A-04-13-00094)
07-07-2016: Medicare Compliance Review of Houston Methodist Hospital for 2012 and 2013 (A-06-14-00074)
07-06-2016: Cornerstone Hospital of Southwest Louisiana Incorrectly Billed Medicare Inpatient Claims with Kwashiorkor (A-03-15-00008)
07-05-2016: Medicare Compliance Review of Christian Hospital for 2012 and 2013 (A-07-15-05075); New Jersey Did Not Adequately Oversee Its Medicaid Nonemergency Medical Transportation Brokerage Program (A-02-14-01001)
06-30-2016: Medicare Compliance Review of University of Tennessee Medical Center (A-04-15-03081); A Florida Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Therapy Services (A-04-15-07054)
06-28-2016: Dominican Hospital Reported Overstated Wage Data, Resulting in Medicare Overpayments (A-09-14-02032)
06-21-2016: International Institute of Sleep, Inc., Billed Medicare for Unallowable Sleep Study Services (A-04-14-07052)
06-20-2016: New York Overpaid Certain Medicaid Mental Health Services Providers (A-02-13-01021)
06-14-2016: A South Texas Physical Therapist Claimed Unallowable Medicare Part B Reimbursement for Outpatient Physical Therapy Services (A-06-14-00064)
06-15-2016: Medicare Compliance Review of Vanderbilt University Medical Center for 2013 and 2014 (A-04-15-08042)
06-13-2016: West Carroll Care Center Did Not Always Follow Care Plans for Residents Who Were Later Hospitalized With Potentially Avoidable Urinary Tract Infections (A-06-14-00073)
06-10-2016: Medicare Improperly Paid Hospitals for Beneficiaries Who Had Not Received 96 or More Consecutive Hours of Mechanical Ventilation (A-09-14-02041)
06-01-2016: Public Summary Report: Washington State Implemented Security Controls Over the Web Site and Database for Its Health Insurance Exchange but Could Improve Protection of Personally Identifiable Information (A-09-15-03005)
05-31-2016: Observations From Our Review of CMS's Administration of the First Performance Year of the Pioneer Accountable Care Organization Payment Model (A-01-13-00509)
05-26-2016: Utah Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-07-14-06057)
05-25-2016: New Jersey Did Not Suspend Medicaid Payments to Some Providers With Credible Allegations of Fraud in Accordance With the Affordable Care Act (A-02-13-01046); Incomplete and Inaccurate Licensure Data Allowed Some Suppliers in Round 2 of the Durable Medical Equipment Competitive Bidding Program That Did Not Have Required Licenses (A-05-13-00047); Connecticut Did Not Comply With Federal and State Requirements for Critical Incidents Involving Developmentally Disabled Medicaid Beneficiaries (A-01-14-00002)
05-24-2016: Precision Health, Inc., Improperly Claimed Medicare Part B Reimbursement for Portable X-ray Services (A-02-13-01038); Medicare Contractors' Payments to Providers for Hospital Outpatient Dental Services in Jurisdictions E and F Generally Did Not Comply With Medicare Requirements (A-06-15-00036); Washington State Claimed Unallowable Federal Medicaid Reimbursement for Some Dental Services (A-09-13-02041)
05-19-2016: Medicare Compliance Review of Sea View Health Care Services, Inc. (A-02-14-01027); Medicare Compliance Review of Huntsville Hospital for 2013 and 2014 (A-04-15-00107)
05-18-2016: Medicare Compliance Review of Wesley Medical Center for 2012 and 2013 (A-07-15-05074)
05-17-2016: New York Made Correct Medicaid Claim Adjustments (A-02-14-01006); CIGNA Government Services, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs for Fiscal Years 2004 Through 2012 (A-07-15-00464)
05-16-2016: Indiana Made Incorrect Medicaid Payments to Providers for Full Vials of Herceptin (A-05-15-00035)
04-28-2016: California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Drugs Provided in Los Angeles County (A-09-15-02017)
04-27-2016: Medicare Compliance Review of Lafayette General Medical Center for Claims Paid During 2013 and 2014 (A-06-15-00022)
04-15-2016: Review of Tufts Medical Center Claims That Included Medical Device Replacements (A-01-15-00503)
04-22-2016: A Florida Physical Therapy Practice Claimed Unallowable Medicare Part B Reimbursement for Some Outpatient Therapy Services (A-04-15-07055)
04-22-2016: Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2014 (A-18-15-30200)
04-15-2016: Palmetto Government Benefits Administrator, LLC, and TrailBlazer Health Enterprises, LLC, Understated Their Medicare Segments' Pension Assets as of January 1, 2005 (A-07-16-00476); Palmetto Government Benefits Administrator, LLC, Claimed Some Unallowable Medicare Pension Costs for Fiscal Years 2003 and 2004 (A-07-16-00477); TrailBlazer Health Enterprises, LLC, Claimed Some Unallowable Medicare Pension Costs for Fiscal Years 2003 and 2004 (A-07-16-00478)
04-12-2016: The Medicaid Program Could Have Achieved Savings if Oregon Had Applied Medical Loss Ratio Standards Similar to Those Established by the Affordable Care Act (A-09-15-02033)
04-07-2016: Some of New York's Claims for Medicaid Long-Term Home Health Care Program Waiver Services were Unallowable (A-02-13-01030); Medicare Contractor Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction H Generally Did Not Comply With Medicare Requirements (A-06-15-00014); Medicare Compliance Review of DePaul Health Center for 2012 and 2013 (A-07-15-05072)
04-05-2016: The Ohio Association of Foodbanks Generally Complied With the Navigator Requirements Related to the Affordable Care Act (A-05-15-00013)
03-31-2016: Wyoming Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-07-15-06063)
03-30-2016: Cornerstone Hospital of Bossier City Incorrectly Billed Medicare Inpatient Claims with Kwashiorkor (A-03-15-00006); Medicare Compliance Review of Saint Louis University Hospital for 2011 and 2012 (A-07-14-05066)
03-29-2016: First Coast Service Options’ Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction N Generally Did Not Comply With Medicare Requirements (A-06-15-00013); Opportunities for Program Improvements Related to States' Withdrawals of Federal Medicaid Funds (A-06-14-00068)
03-24-2016: North Carolina Did Not Always Make Correct Medicaid Claim Adjustments (A-04-14-00100)
03-23-2016: Group Health Incorporated Claimed Unallowable Medicare Pension Costs for Plan Years 2007 and 2008 (A-07-16-00475); California Improperly Claimed Enhanced Federal Reimbursement for Selected Claim Lines for Medicaid Family Planning Drugs and Supplies in Los Angeles and Orange Counties (A-09-15-02014)
03-17-2016: Wisconsin Physicians Service's Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction 5 and Jurisdiction 8 Generally Did Not Comply With Medicare Requirements (A-06-15-00034); Missouri Claimed Unallowable Medicaid Payments for Individualized Supported Living Habilitation Services (A-07-14-03202); A Texas Physical Therapist Claimed Unallowable Medicare Part B Reimbursement for Outpatient Therapy Services (A-06-14-00065)
03-16-2016: The Medicare Contractors for Jurisdiction E Overpaid Claims for Replaced Cardiac Medical Devices When Hospitals Had Not Reported Manufacturer Credits (A-09-15-02029)
03-14-2016: Oregon Properly Verified Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-09-16-02007)
03-09-2016: Not All of the Vermont Marketplace's Internal Controls Were Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements (A-01-14-02507)
03-08-2016: Medicare Compliance Review of Billings Clinic Hospital for 2012 and 2013 (A-07-15-05071)
03-07-2016: Maryland Claimed Unallowable Costs for Medicaid Communicable Disease Care Services (A-03-14-00150)
03-04-2016: Medicare Compliance Review of Freeman Hospital for 2011 and 2012 (A-07-14-05064)
02-26-2016: Texas Inappropriately Received Medicaid Medical Assistance Funding for Some Costs (A-06-15-00054)
02-24-2016: Texas Inappropriately Claimed Medicaid Balancing Incentive Payments Program and Family Planning Funding (A-06-14-00059); Some of New Jersey's Claims for Medicaid Global Options for Long-Term Care Waiver Services Were Unallowable (A-02-14-01008)
02-22-2016: Not All of the District of Columbia Marketplace's Internal Controls Were Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements (A-03-14-03301)
02-17-2016: Medicare Compliance Review of Hennepin County Medical Center for 2012 and 2013 (A-05-14-00048); Nevada Misallocated Costs for Establishing a Health Insurance Marketplace to Its Establishment Grants (A-09-14-01007)
02-12-2016: Medicare Compliance Review of Greenville Memorial Hospital (A-04-15-03082); Not All of the Minnesota Marketplace's Internal Controls Were Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements (A-05-14-00043)
02-11-2016: Public Summary Report: South Carolina Did Not Meet Federal Information System Security Requirements for Safeguarding Medicaid Management Information System Data and Supporting Systems (A-04-13-05049)
02-10-2016: Public Summary Report: Connect for Health Colorado Generally Protected Personally Identifiable Information on Its Health Insurance Exchange Web Sites and Databases but Could Continue To Improve Information Security Controls (A-07-15-00454)
02-09-2016: South Dakota Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-07-15-06059)
02-01-2016: Medicare Did Not Pay Selected Inpatient Claims for Bone Marrow and Stem Cell Transplant Procedures in Accordance With Medicare Requirements (A-09-14-02037); Promise Hospital of Ascension Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-15-00007)
01-27-2016: CIGNA Government Services, LLC's Postretirement Benefit Allocable Costs Were Reasonable and Allowable for Calendar Years 2007 Through 2011 (A-07-15-00465)
01-25-2016: Medicare Compliance Review of University of Minnesota Medical Center for 2012 and 2013 (A-05-14-00050)
01-22-2016: Review of Medicare Payments for Laboratory Tests Billed With an AY Modifier by Total Renal Laboratories, Inc. (A-01-14-00505); Review of Medicare Payments for Laboratory Tests Billed With an AY Modifier by DVA Laboratory Services, Inc. (A-01-14-00508)
01-20-2016: Inadequate Security Management Practices Left Utah Department of Health Sensitive Medicaid Data at Risk of Unauthorized Disclosure (A-07-15-00455)
01-19-2016: Not All of the Washington Marketplace’s Internal Controls Were Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements (A-09-14-01006)
01-14-2016: Montana Correctly Claimed Federal Reimbursement for Most Medicaid Physician-Administered Drugs (A-07-15-06062)
01-13-2016: Danbury Hospital Reported Overstated Wage Data Resulting in Medicare Overpayments (A-01-14-00506); North Dakota Correctly Claimed Federal Reimbursement for Most Medicaid Physician-Administered Drugs (A-07-15-06058)
01-12-2016: We Could Not Determine Whether West Virginia's Severance and Business Privilege Tax on Behavioral Health Services Is a Permissible Health-Care-Related Tax (A-03-14-00200)
01-07-2016: California Claimed Unallowable Federal Medicaid Reimbursement by Not Billing Manufacturers for Rebates for Some Physician-Administered Drugs (A-09-14-02038)

2015

12-31-2015: CMS Could Not Effectively Ensure That Advance Premium Tax Credit Payments Made Under the Affordable Care Act Were Only for Enrollees Who Paid Their Premiums (A-02-14-02025)
12-30-2015: California Incorrectly Claimed Medicaid Expenditures for Indian Health Service Facilities on the CMS-64 (A-05-15-00018)
12-28-2015: Not All of the Colorado Marketplace's Internal Controls Were Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements (A-07-14-03199)
12-23-2015: New York State Improperly Claimed Medicaid Reimbursement for Some Adult Day Health Care Services (A-02-13-01016)
12-17-2015: California Withdrew Excessive Federal Medicaid Funds for Fiscal Year 2010 (A-09-13-02001)
12-16-2015: Average Manufacturer Prices Increased Faster Than Inflation for Many Generic Drugs (A-06-15-00030)
12-14-2015: South Carolina Incorrectly Claimed Medicaid Expenditures for Indian Health Service Facilities on the CMS-64 (A-05-15-00016)
12-10-2015: Medicare Compliance Review of Nebraska Methodist Hospital for 2012 and 2013 (A-07-15-05073)
12-09-2015: Englewood Hospital and Medical Center Claimed Unallowable Medicare Part B Reimbursement for Outpatient Cardiac and Pulmonary Rehabilitation Services (A-02-14-01013)
12-07-2015: Alaska Incorrectly Claimed Medicaid Expenditures for Indian Health Service Facilities on the CMS-64 (A-05-15-00017); Oregon Incorrectly Claimed Medicaid Expenditures for Indian Health Service Facilities on the CMS-64 (A-05-15-00014)
12-03-2015: Hoveround Corporation Claimed Millions in Federal Reimbursement for Power Mobility Devices That Did Not Meet Medicare Requirements (A-05-12-00057)
11-30-2015: High-Risk Security Vulnerabilities Identified During Reviews of Information System General Controls at Three California Managed-Care Organizations Raise Concerns About the Integrity of Systems Used To Process Medicaid Claims (A-09-15-03004)
11-25-2015: New York Claimed Medicaid Reimbursement for Some Adult Day Health Care Services Provided by Center for Nursing and Rehabilitation That Were Unallowable (A-02-12-01015); New York Claimed Medicaid Reimbursement for Some Adult Day Health Care Services Provided by Metropolitan Jewish Health System That Were Unallowable (A-02-12-01024)
11-24-2015: New Mexico Received Millions in Unallowable Bonus Payments (A-04-15-08040)
11-19-2015: Medicare Compliance Review of University of California, Davis, Medical Center for 2011 Through 2013 (A-09-14-02036)
11-12-2015: Medicare Compliance Review of Sierra View Medical Center (A-09-14-02039)
11-17-2015: National Government Services, Inc., Made Medicare Payments for Diabetic Test Strips When Beneficiaries Had Not Nearly Exhausted Previously Dispensed Supplies (A-09-15-02001)
11-04-2015: The District of Columbia Claimed Allocated Costs to Its Establishment Grants in Accordance With Federal Requirements (A-03-14-03300)
10-30-2015: Vermont Obtained CMS Approval to Report Certain Primary Care Service Expenditures in the Indian Health Service Facilities Column on the CMS-64 (A-05-15-00019); Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part A Administrative Costs for FYs 2009, 2010, and 2011 (A-05-13-00020); Wisconsin Physicians Service Insurance Corporation Claimed Unallowable Medicare Part B Administrative Costs for FYs 2009, 2010, and 2011 (A-05-13-00019)
10-29-2015: Boulevard Health Care, Inc., Improperly Claimed Medicare Reimbursement for Outpatient Physical Therapy Services (A-02-14-01004)
10-27-2015: Medicare Compliance Review of Naples Community Hospital for 2011 and 2012 (A-04-14-07049)
10-23-2015: Wisconsin Improperly Claimed Enhanced Federal Reimbursement for Some Non-Family Planning Services (A-05-13-00034)
10-20-2015: The Medicaid Program Could Have Achieved Savings if New York Applied Medical Loss Ratio Standards Similar to Those Established by the Affordable Care Act (A-02-13-01036); Medicare Compliance Review of Boca Raton Regional Hospital, Inc., for 2011 and 2012 (A-04-14-07048)
10-19-2015: Kindred Hospital of Central Ohio Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-15-00002)
10-15-2015: Most Medicaid Payments Oklahoma Made to Providers for Full Vials of Herceptin Were Correct (A-06-15-00023); Wisconsin Inappropriately Withdrew Federal Medicaid Funds for Fiscal Years 2010 Through 2012 (A-05-13-00045)
10-14-2015: Total Sleep Management, Inc., Billed Medicare for Unallowable Sleep Study Services (A-04-14-07051); The Kentucky Marketplace's Internal Controls Were Generally Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements (A-04-14-08036)
10-07-2015: Medicare Compliance Review of Altru Hospital for 2012 and 2013 (A-07-15-05070)
09-30-2015: Delaware Medicaid Electronic Health Record Payments (A-03-14-00402); Massachusetts Generally Complied With Medicaid Requirements When Claiming Reimbursement for School-Based Health Services (A-01-14-00003)
09-28-2015: Review of Intermediate Care Facilities in New York With High Rates of Emergency Room Visits by Intellectually Disabled Medicaid Beneficiaries (A-02-14-01011); National Government Services, Inc., Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments (A-05-11-00016)
09-21-2015: State Medicaid Agencies Can Significantly Reduce Medicaid Costs for Durable Medical Equipment and Supplies (A-05-15-00025); Arkansas Complied With the Requirements of the Affordable Care Act in Its Review of Cases of Credible Allegations of Medicaid Fraud (A-06-15-00026); Some Pennsylvania Family Child Day Care Centers Did Not Always Comply With State Health and Safety Requirements (A-03-14-00251); Not All Internal Controls Implemented by the New York Marketplace Were Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements (A-02-14-02020)
09-18-2015: Kansas Correctly Claimed Federal Reimbursement for Most Medicaid Physician-Administered Drugs (A-07-14-06056); CMS Did Not Identify All Federal Marketplace Contract Costs and Did Not Properly Validate the Amount To Withhold for Defect Resolution on the Principal Federal Marketplace Contract (A-03-14-03002); Utah Correctly Claimed Most of Its Medicaid Supplemental Physicians' Payments (A-07-14-01149)
09-14-2015: CMS's Reliance on Puerto Rico's Certification Surveys Could Not Ensure the Safety of Medicare Beneficiaries Who Received Home Health Care Services Provided by St. Luke's Home Health Agency - Juana Diaz (A-02-11-01030); Public Summary Report: The Centers for Medicare & Medicaid Services' Implementation of Security Controls Over the Multidimensional Insurance Data Analytics System Needs Improvement (A-06-14-00067); CMS Did Not Always Manage and Oversee Contractor Performance for the Federal Marketplace as Required by Federal Requirements and Contract Terms (A-03-14-03001)
09-03-2015: Vibra Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-15-00001); Oklahoma Made Incorrect Medicaid Electronic Health Record Incentive Payments to Health Care Professionals (A-06-14-00030)
09-01-2015: TrailBlazer Health Enterprises, LLC, Did Not Claim Some Allowable Medicare Postretirement Benefit Costs for Fiscal Years 2005 Through 2011 (A-07-15-00461); TrailBlazer Health Enterprises, LLC, Understated Its Allocable Medicare Postretirement Benefit Plan Costs for Calendar Years 2008 Through 2013 (A-07-15-00462)
08-31-2015: Washington State Did Not Suspend Medicaid Payments to Some Providers With Credible Allegations of Fraud in Accordance With the Affordable Care Act (A-09-14-02018); Texas Made Incorrect Medicaid Electronic Health Record Incentive Payments (A-06-13-00047)
08-26-2015: Providers Did Not Always Reconcile Patient Records With Credit Balances and Report and Return the Associated Medicaid Overpayments to State Agencies (A-04-14-04029); Some of New Jersey's Claims for Medicaid Personal Care Services Did Not Comply With Federal and State Requirements (A-02-13-01022); Medicare Compliance Review of Moses H. Cone Memorial Hospital for 2012 (A-04-14-04023)
08-24-2015: Maine Did Not Implement Both Recommendations From a Prior Review of Medicaid Overpayments to Nursing Facilities (A-01-14-00007)
08-20-2015: Jefferson Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor
08-19-2015: National Government Services Claimed Allowable Administrative Costs for Fiscal Year 2010 and the First Quarter of Fiscal Year 2011 under Medicare Contract 00450 (A-05-14-00025); National Government Services Claimed Allowable Administrative Costs for Fiscal Year 2010 and the First Quarter of Fiscal Year 2011 Under Medicare Contract 00130 (A-05-14-00024)
08-14-2015: Medicare Compliance Review of Saint Luke's Hospital of Chesterfield for 2011 and 2012 (A-07-14-05063)
08-12-2015: Missouri Claimed Unallowable and Unsupported Medicaid Payments for Group Home Habilitation Services (A-07-14-03201)
08-10-2015: Not All of the Federally Facilitated Marketplace's Internal Controls Were Effective in Ensuring That Individuals Were Properly Determined Eligible for Qualified Health Plans and Insurance Affordability Programs (A-09-14-01011)
08-07-2015: Connecticut Claimed Unallowable Medicaid Payments for Targeted Case Management Services Provided to Individuals With Chronic Mental Illness (A-01-14-00001)
07-30-2015: Medicare Compliance Review of Mary Hitchcock Memorial Hospital for 2009 through 2012 (A-01-13-00513)
07-29-2015: CGS Administrators, LLC, Made Medicare Payments for Diabetic Test Strips When Beneficiaries Had Not Nearly Exhausted Previously Dispensed Supplies (A-09-14-02015); Actual Enrollment and Profitability Was Lower Than Projections Made by the Consumer Operated and Oriented Plans and Might Affect Their Ability to Repay Loans Provided Under the Affordable Care Act (A-05-14-00055)
07-28-2015: Medicare Contractors' Payments to Providers for Hospital Outpatient Dental Services in Kentucky and Ohio Did Not Comply With Medicare Requirements (A-06-14-00020); California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Drugs Provided in Orange County (A-09-14-02028)
07-27-2015: Most Medicaid Payments Arkansas Made to Providers for Full Vials of Herceptin Were Incorrect (A-06-14-00032); Medicare Part B Overpaid Millions for Selected Outpatient Drugs (A-09-14-02024)
07-22-2015: New Jersey Improperly Claimed Medicaid Reimbursement for Some Home Health Claims Submitted by Home Health Agencies (A-02-12-01012); Iowa Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-07-14-06049); Alleviate Wellness Center Received Unallowable Medicare Payments for Chiropractic Services (A-09-14-02027); Palmetto Government Benefits Administrator Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments in Jurisdiction 1 (A-07-13-02795)
07-23-2015: Medicare Contractors' Payments to Providers for Hospital Outpatient Dental Services in Jurisdiction K Did Not Comply With Medicare Requirements (A-06-14-00022)
07-21-2015: North Carolina Received Millions in Unallowable Bonus Payments (A-04-14-08035)
07-09-2015: Washington State Did Not Always Verify Correction of Deficiencies Identified During Surveys of Nursing Homes Participating in Medicare and Medicaid (A-09-13-02039)
07-01-2015: Medicare Compliance Review of Saint Mary's Health Center for 2011 and 2012 (A-07-14-05065)
06-30-2015: The Medicare Contractor for Jurisdiction 1 Overpaid a Provider That Incorrectly Billed for Aflibercept (A-06-14-00055)
06-29-2015: Maryland Claimed Unallowable Medicaid Costs for Residential Habilitation Add-on Services Under Its Community Pathways Waiver Program (A-03-13-00202)
06-26-2015: Hospice of New York, LLC, Improperly Claimed Medicare Reimbursement for Some Hospice Services (A-02-13-01001)
06-25-2015: CMS's Reliance on New Jersey Licensure Requirements Could Not Ensure the Quality of Care Provided to Medicaid Hospice Beneficiaries (A-02-11-01024)
06-22-2015: Arkansas Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals (A-06-14-00010); Wisconsin Physicians Service Insurance Corporation Overpaid a Provider That Incorrectly Billed for Aflibercept (A-06-14-00051)
06-17-2015: Medicare Compliance Review of the University of Kentucky HealthCare for 2011 and 2012 (A-04-13-08026)
06-16-2015: CMS's Reliance on Accreditation Surveys Could Not Ensure the Quality of Care Provided to Medicare Hospice Beneficiaries by The Community Hospice, Inc. (A-02-11-01027); CMS's Internal Controls Did Not Effectively Ensure the Accuracy of Aggregate Financial Assistance Payments Made to Qualified Health Plan Issuers Under the Affordable Care Act (A-02-14-02006)
06-15-2015: Massachusetts Made Claim Adjustments in Accordance With Federal Time Limit Regulations (A-01-15-00001); Some of the State-Operated Medicaid Program Expenditures Claimed by Missouri During the Period October 1, 2010, Through June 30, 2012, Were Unallowable (A-07-14-03197); New York Did Not Have Evidence Available in Readily Reviewable Form To Support That It Reimbursed Medicaid Diabetic Testing Supply Rebates to the Federal Government (A-02-13-01002); AgeWell Physical Therapy & Wellness, P.C., Claimed Unallowable Medicare Part B Reimbursement for Outpatient Therapy Services (A-02-13-01031)
06-10-2015: CMS's Reliance on New Jersey Qualification Requirements Could Not Ensure the Quality of Care Provided to Medicaid Beneficiaries Receiving Home Health Services (A-02-11-01019); CMS's Reliance on Puerto Rico's Certification Surveys Could Not Ensure the Quality of Care Provided to Medicare Hospice Beneficiaries by Servicios Suplementarios de Salud, Inc. (A-02-11-01028)
06-05-2015: The Fraud Prevention System Increased Recovery and Prevention of Improper Medicare Payments, but Updated Procedures Would Improve Reported Savings (A-01-14-00503)
06-04-2015: Most Medicaid Payments Texas Made to Providers for Full Vials of Herceptin Were Incorrect (A-06-14-00042); Illinois Improperly Claimed Medicaid Reimbursement for Optical Services and Supplies (A-05-13-00046)
06-03-2015: Texas Paid Millions for Unallowable Medicaid Orthodontic Services (A-06-11-00048)
06-01-2015: The Hospital of Central Connecticut Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-15-00003)
05-29-2015: CGS Administrators, LLC, Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments (A-07-13-02791)
05-28-2015: National Government Services Claimed Allowable Administrative Costs for Fiscal Year 2010 and the First Quarter of Fiscal Year 2011 (A-05-14-00032); TrustSolutions, LLC, Overstated Its Allocable Pension Costs for Calendar Years 2007 Through 2009 (A-07-14-00451); TrustSolutions, LLC, Understated Its Medicare Segment Pension Assets as of January 1, 2010 (A-07-14-00449)
05-27-2015: Advanced Chiropractic Services Received Unallowable Medicare Payments for Chiropractic Services (A-07-13-01128); Medicare Compliance Review of Loma Linda University Medical Center for 2011 and 2012 (A-09-13-02056)
05-26-2015: United Government Services, LLC, Understated Its Medicare Segment Pension Assets as of January 1, 2010 (A-07-14-00447); United Government Services, LLC, Claimed Some Unallowable Medicare Pension Costs for Fiscal Years 1999 Through 2006 (A-07-14-00450)
05-22-2015: Minnesota Underreported the Federal Share and Did Not Accurately Report All Medicaid Overpayment Collections (A-05-14-00018)
05-21-2015: National Government Services, Inc., Understated Its Allocable Pension Costs for Calendar Years 2006 Through 2009 (A-07-14-00453)
05-20-2015: National Government Services, Inc., Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2007 Through 2009 (A-07-14-00452)
05-19-2015: Cox Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-15-00004)
05-15-2015: CMS's Reliance on New York Qualification Requirements Could Not Ensure the Quality of Care Provided to Medicaid Beneficiaries Receiving Home Health Services (A-02-11-01013); First Coast Service Options, Inc., Paid Some Unallowable Sleep Study Claims (A-04-13-07039)
05-14-2015: Medicare Compliance Review of Saint Luke's Hospital of Kansas City for 2011 and 2012 (A-07-14-05062); CGS Administrators, LLC, Overpaid Providers That Incorrectly Billed for Aflibercept (A-06-14-00053); Medicare Compliance Review of Saint Anthony's Medical Center for 2011 and 2012 (A-07-14-05059)
05-06-2015: Incorrect Place-of-Service Coding Resulted in Potential Medicare Overpayments Costing Millions (A-01-13-00506)
05-04-2015: Arizona Correctly Claimed Medicaid expenditures for Indian Health Service Facilities on the CMS-64 (A-05-15-00015); Texas Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-06-12-00060)
04-30-2015: New Jersey Claimed Medicaid Hospice Services That Were Not in Compliance With Federal and State Requirements (A-02-11-01014); California Implemented Security Controls Over the Web Site and Databases for Its Health Insurance Exchange but Could Improve Protection of Personally Identifiable Information (A-09-14-03005)
04-29-2015: Cedar Ridge Did Not Always Provide the Required Treatment and Therapy Hours for Residential Treatment and Acute Care (A-06-14-00029)
04-28-2015: South Carolina Claimed Some Unallowable Room-and-Board Costs Under the Intellectual and Related Disabilities Waiver for State Fiscal Year 2010 (A-04-14-04019)
04-27-2015: Early Alert: Without Clearer Guidance, Marketplaces Might Use Federal Funding Assistance for Operational Costs When Prohibited by Law (A-01-14-02509)
04-23-2015: Palmetto Government Benefits Administrator Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments in Jurisdiction 11 (A-07-10-02775)
04-21-2015: National Heritage Insurance Corporation Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments (A-05-11-00024); Palmetto GBA, LLC, Applied the Senior Executive Compensation Benchmark in Accordance With Federal Regulations (A-04-14-00102)
04-17-2015: Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2013 (A-18-14-30500)
04-14-2015: Medicare Compliance Review of Florida Hospital Orlando for the Period January 1, 2011, Through June 30, 2012 (A-04-13-07043)
04-13-2015: Missouri Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-07-14-06051)
04-07-2015: Lone Star Circle of Care Complied With Federal Requirements Related to Its Affordable Care Act-Funded Community Health Center Fund Grant (A-06-14-00058); Colorado Paid Over 800 Thousand Medicaid Claims With Missing or Invalid National Provider Identifiers During 2011 (A-07-13-06042)
03-30-2015: California Claimed Medicaid Reimbursement for Certain Nonemergency Medical Transportation Services in Los Angeles County Billed as Exempt From Prior Authorization That Did Not Comply With Federal and State Requirements (A-09-13-02054); Cahaba Government Benefit Administrators, LLC, Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments (A-05-11-00019)
03-27-2015: Novitas Solutions, Inc. (Formerly Highmark Medicare Services, Inc.), Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments (A-05-11-00023); First Coast Service Options, Inc., Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments (A-05-11-00022)
03-26-2015: Iowa Did Not Always Make Correct Medicaid Adjustments (A-07-14-01135); North Carolina Claimed Federal Medicaid Reimbursement for Dental Services That Did Not Always Comply With Federal and State Requirements (A-04-13-04014); Maryland Misallocated Millions to Establishment Grants for a Health Insurance Marketplace (A-01-14-02503)
03-18-2015: Wisconsin Received Some Unallowable Bonus Payments (A-04-13-08021)
03-17-2015: Texas Claimed Unallowable Federal Reimbursement for Some Family Planning Services (A-06-11-00016)
03-16-2015: National Government Services, Inc., Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments in Jurisdiction 8 (A-05-14-00046)
03-09-2015: Ohio Did Not Always Comply With the Requirements of the Affordable Care Act in its Review of Cases of Credible Allegations of Medicaid Fraud (A-05-14-00008)
03-06-2015: Medicare Could Have Saved Billions at Critical Access Hospitals If Swing-Bed Services Were Reimbursed Using the Skilled Nursing Facility Prospective Payment System Rates (A-05-12-00046)
03-04-2015: Oregon Did Not Bill Manufacturers for Rebates for Physician-Administered Drugs Dispensed to Enrollees of Medicaid Managed-Care Organizations (A-09-13-02037); New York State Improperly Claimed Medicaid Reimbursement for Continuous 24-Hour Personal Care Claims in Ulster County (A-02-14-01003)
03-03-2015: Medicare Compliance Review of Northwestern Memorial Hospital for 2011 and 2012 (A-05-13-00051)
03-01-2015: Medicare Compliance Review of Mercy Hospital in Saint Louis for 2011 and 2012 (A-07-14-05057)
02-27-2015: Rex Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-14-00008); New York Hospital Queens Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00030)
02-26-2015: New York State Improperly Claimed Medicaid Reimbursement for Continuous 24-Hour Personal Care Claims (A-02-12-01004)
02-13-2015: CMS Made Payments Associated With Providers After Referring Individual Providers' Debts to the Department of the Treasury for Collection (A-02-12-01008)
02-10-2015: Louisiana Complied With the Federal Medicaid Requirements for Billing Manufacturers for Rebates for Physician-Administered Drugs (A-06-14-00031)
02-05-2015: Prosthetic Science San Antonio, Inc., Generally Met Medicare Documentation Requirements for Lower Limb Prosthetic Claims (A-06-14-00034)
02-04-2015: The New York Medicaid Program Could Significantly Lower Payment Rates for Selected Durable Medical Equipment and Supplies (A-02-13-01042)
02-02-2015: Most Medicaid Payments the State of Illinois Made to Providers for Full Vials of Herceptin Were Incorrect (A-05-14-00023); Medicare Compliance Review of University of North Carolina Hospitals for the Period January 1, 2011, Through September 30, 2012 (A-04-13-04018)
01-30-2015: Methodist Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-14-00005); Acute-Care Hospitals in Ohio Did Not Always Reconcile Invoice Records With Credit Balances and Refund the Associated Medicaid Overpayments to the State Agency (A-05-12-00070)
01-29-2015: Review of Beth Israel Deaconess Medical Center Claims That Included Medical Device Replacements (A-01-14-00502)
01-28-2015: Medicare Compliance Review of Missouri Baptist Medical Center for 2011 and 2012 (A-07-14-05058); Medicare Compliance Review of Utah Valley Regional Medical Center for 2010 and 2011 (A-07-13-05048)
01-27-2015: Medicare Compliance Review of Iowa Methodist Medical Center for 2010 and 2011 (A-07-13-05042)
01-23-2015: California Claimed Medicaid Reimbursement for Some Nonemergency Medical Transportation Services That Did Not Comply With Federal and State Requirements (A-09-13-02033)
01-16-2015: Medicare Paid Suppliers for Power Mobility Device Claims That Did Not Meet Federal Requirements for Physicians' Face-to-Face Examinations of Beneficiaries (A-09-12-02068)
01-15-2015: The District of Columbia Made Correct Medicaid Electronic Health Record Incentive Payments to Hospitals (A-03-14-00401)
01-13-2015: Palmetto Government Benefits Administrator, LLC, Claimed Unallowable Medicare Excess Plan Costs for Fiscal Years 2005 Through 2011 (A-07-14-00443)
01-07-2015: Medicare Compliance Review of St. Vincent Healthcare for 2011 and 2012 (A-07-13-05052)
01-06-2015: New York Claimed Some Unallowable Costs for Services by New York State Providers Under the State's Developmental Disabilities Waiver Program (A-02-10-01044)

2014

12-29-2014: Medicare Compliance Review of Ochsner Medical Center for the Period January 1, 2011, Through September 30, 2012 (A-06-13-00042); CMS Did Not Always Correctly Make Clinic Visit Payments to Hospitals During Calendar Year 2012 (A-04-13-06168)
12-23-2014: Baptist Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-14-00007); Indiana Underreported the Federal Share and Did Not Accurately Report All Medicaid Overpayment Collections (A-05-13-00052)
12-16-2014: Noridian Healthcare Solutions, LLC, Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments (A-07-10-02774)
12-12-2014: TrailBlazer Health Enterprises, LLC, Claimed Some Unallowable Medicare Excess Plan Costs for Fiscal Years 2005 Through 2011 (A-07-14-00444); Blue Cross Blue Shield of South Carolina Overstated Its Allocable Medicare Excess Plan Costs for Calendar Years 2006 Through 2011 (A-07-14-00445)
12-11-2014: Medicare Compliance Review of Stormont-Vail Regional Health Center for 2011 and 2012 (A-07-13-05051)
12-10-2014: Medicare Compliance Review of Boone Hospital for 2010 and 2011 (A-07-13-05043)
12-05-2014: Medicare Compliance Review of University of Missouri Health Center for 2010 and 2011 (A-07-13-05050)
11-25-2014: CGS Administrators, LLC, Claimed Some Unallowable Medicare Excess Plan Costs for Fiscal Year 2011 (A-07-14-00448)
11-24-2014: Highmark Medicare Services, Inc., Claimed Some Unallowable Medicare Postretirement Benefit Costs for Fiscal Years 2003 Through 2009 (A-07-14-00438)
11-21-2014: Minnesota Complied With the Requirements of the Affordable Care Act in its Review of Cases of Credible Allegations of Medicaid Fraud. (A-05-14-00009)
11-20-2014: Cahaba Government Benefit Administrators, LLC, Applied the Senior Executive Compensation Benchmark in Accordance With Federal Regulations (A-04-13-00089)
11-18-2014: Wisconsin Physicians Service Insurance Corporation Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments (A-07-10-02777)
11-17-2014: Highmark Medicare Services, Inc., Overstated Its Allocable Medicare Postretirement Benefit Plan Costs for Calendar Years 2008 Through 2011 (A-07-14-00439); New Jersey Claimed Excessive Medicaid Disproportionate Share Hospital Payments for Five County-Operated Psychiatric Facilities (A-02-13-01035); Massachusetts Made Incorrect Medicaid Electronic Health Record Incentive Payments to Hospitals (A-01-13-00008)
11-05-2014: Blue Cross Blue Shield of South Carolina Overstated Its Allocable Medicare Supplemental Executive Retirement Plan III Costs for Calendar Years 2010 and 2011 (A-07-14-00442)
10-30-2014: Missouri Claimed Unallowable Medicaid Payments for Targeted Case Management Services Provided to Individuals With Developmental Disabilities (A-07-13-03193); Palmetto Government Benefits Administrator, LLC, Claimed Unallowable Medicare Supplemental Executive Retirement Plan III Costs for Fiscal Years 2010 and 2011 (A-07-14-00441)
10-29-2014: Medicare Overpayments in Jurisdiction 15 for Unreported Cardiac Device Credits (A-05-13-00029); Pinnacle Business Solutions Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments (A-07-11-02773)
10-27-2014: Medicare Compliance Review of the Queen's Medical Center for the Period January 1, 2010, Through September 30, 2012 (A-09-14-02014); Medicare Compliance Review of Oregon Health & Science University for 2010 Through 2012 (A-09-13-02057)
10-22-2014: Nebraska Incorrectly Claimed Federal Reimbursement for Inpatient Claims With Sterilization and Delivery Procedures for the Period April 1, 2011, Through December 31, 2013 (A-07-14-01136); Medicare Compliance Review of Avera McKennan Hospital for 2010 and 2011 (A-07-13-05044); Medicare Compliance Review of Methodist Healthcare - Memphis Hospitals for the Period January 1, 2011, Through June 30, 2012 (A-04-13-00093); Medicare Compliance Review of Hackensack University Medical Center for the Period April 1, 2011, through September 30, 2012 (A-02-13-01017)
10-20-2014: Medicare Compliance Review of Yale-New Haven Hospital for 2010 and 2011 (A-01-13-00502); Texas Did Not Always Comply With Federal and State Requirements for Claims Submitted for the Nonemergency Medical Transportation Program (A-06-12-00053)
10-10-2014: Overlook Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-14-00003)
10-09-2014: TrailBlazer Health Enterprises, LLC, Claimed Unallowable Medicare Part B Termination Costs (A-06-13-00017)
10-02-2014: Medicare Compliance Review of Mission Hospital for the Period January 1, 2011, through December 31, 2012 (A-04-14-03077)
09-29-2014: National Heritage Insurance Company Claimed Some Unallowable Benefit Restoration Plan Costs for Fiscal Years 2003 Through 2009 (A-07-14-00435); National Heritage Insurance Company Did Not Claim Some Allowable Supplemental Executive Retirement Plan Costs for Fiscal Years 2003 Through 2009 (A-07-13-00427); Some of New York's Claims for Medicaid Supported Employment Services Were Unallowable (A-02-13-01004); Massachusetts Did Not Always Make Correct Medicaid Claim Adjustments (A-01-13-00003)
09-26-2014: Providence Portland Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00034); Medicare Compliance Review of Orlando Health for the Period January 1, 2011, Through June 30, 2012 (A-04-13-07042); Colorado Claimed Unallowable Medicaid Nursing Facility Supplemental Payments (A-07-14-04215)
09-23-2014: The Community Hospice, Inc., Improperly Claimed Medicare Reimbursement for Some Hospice Services (A-02-11-01016)
09-22-2014: Credit Balances at Children's Hospital & Research Center Oakland Represented Overpayments That Had Not Been Returned to the Medicaid Program (A-09-13-02058); Health Insurance Marketplaces Generally Protected Personally Identifiable Information but Could Improve Certain Information Security Controls (A-18-14-30011)
09-15-2014: Medicare Part B Prescription Drug Dispensing and Supplying Fee Payment Rates Are Considerably Higher Than the Rates Paid by Other Government Programs (A-06-12-00038)
09-09-2014: Mother Frances Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-14-00006); Review of Physician Supplemental Payments Made to the University of North Texas (A-06-10-00082); Washington Received Millions in Unallowable Bonus Payments (A-04-14-08028)
09-08-2014: Alabama Withdrew Excessive Federal Medicaid Funds for Fiscal Years 2010 Through 2012 (A-06-13-00026)
09-05-2014: CMS's Reliance on Ohio Licensure Requirements Did Not Always Ensure the Quality of Care Provided to Medicaid Hospice Beneficiaries (A-05-12-00086)
09-04-2014: Medicare Compliance Review of Cox Medical Center for 2010 and 2011 (A-07-12-05038); Medicare Compliance Review of Genesis Medical Center for 2010 and 2011 (A-07-13-05041); Review of Outpatient Surgeries Billed by Tulare Regional Medical Center (A-09-13-02052)
08-26-2014: Louisiana Made Incorrect Medicaid Electronic Health Record Incentive Payments (A-06-12-00041)
08-21-2014: The District of Columbia Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-03-12-00205)
08-20-2014: An Illinois Physical Therapist Claimed Unallowable Medicare Part B Reimbursement for Outpatient Therapy Services (A-05-13-00010)
08-19-2014: Tyler Prosthetics, Inc., Generally Met Medicare Documentation Requirements for Lower Limb Prosthetic Claims (A-06-13-00049)
08-16-2013: Massachusetts Medicaid Payments to Golden Living Centers Did Not Comply with Federal and State Requirements (A-01-13-00007)
08-13-2014: Review of Outpatient Surgeries Billed by Hazel Hawkins Memorial Hospital (A-09-13-02053)
08-12-2014: California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Services Provided in Southeast Los Angeles County (A-09-13-02047)
08-08-2014: Florida Made Medicaid Electronic Health Record Payments to Hospitals in Accordance With Federal and State Requirements (A-04-13-06164); Some Hospitals in Florida and Puerto Rico Claimed Residents as More Than One Full-Time Equivalent (A-02-13-01014)
08-07-2014: Illinois' Federal Medicaid Withdrawals Were Supported by Net Expenditures for Fiscal Years 2010 Through 2012 (A-06-13-00032); Servicios Suplementarios de Salud, Inc., Improperly Claimed Medicare Reimbursement for Some Hospice Services (A-02-11-01017); Nebraska Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-07-13-06040)
08-06-2014: Texas Did Not Ensure That the Prior-Authorization Process Was Used To Determine the Medical Necessity of Orthodontic Services (A-06-12-00039); Kansas Improperly Received Medicaid Reimbursement for School-Based Health Services (A-07-13-04207)
07-31-2014: Medicare Compliance Review of Norton Healthcare, Inc., for the Period January 1, 2011, Through June 30, 2012 (A-04-13-08024); The Centers for Medicare & Medicaid Services Provided Medicare Part D Coverage to Beneficiaries Confined in Mental Health Facilities for Court-Ordered Purposes (A-07-13-06041); Weaknesses in Molina's Information System General Controls Over Its Medicaid Claims Processing System Increase Vulnerabilities (A-09-13-03001)
07-29-2014: Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2012 (A-18-14-30100)
07-25-2014: California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Services Provided in Central Los Angeles County (A-09-13-02012); California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Services Provided in Orange County (A-09-13-02044); California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Services Provided in East Los Angeles County (A-09-13-02019)
07-18-2014: The Medicare Contractor for Jurisdiction 14 Overpaid Providers for Selected Outpatient Drugs (A-01-13-00504)
07-16-2014: Medicare Compliance Review of Good Samaritan Hospital for Calendar Years 2010 and 2011 (A-09-13-02008)
07-14-2014: New Jersey Did Not Comply With Recovery Act Requirements for Receiving Increased Federal Medicaid Assistance (A-02-11-01039)
07-10-2014: Virginia Improperly Claimed Federal Reimbursement for Most Reviewed Medicaid Payments to Piedmont Geriatric Hospital (A-05-12-00056); Virginia Improperly Claimed Federal Reimbursement for Most Reviewed Medicaid Payments to Catawba Hospital (A-05-12-00055); Louisiana Received More Than $7.1 Million in Unallowable Bonus Payments (A-04-14-08029)
07-09-2014: Some Hospitals in Alabama, Georgia, and Tennessee Claimed Residents as More Than One Full-Time Equivalent (A-02-13-01012)
07-07-2014: The Rhode Island Medicaid Program Could Lower Payments for Selected Durable Medical Equipment and Supplies (A-01-13-00006)
07-03-2014: The Medicare Contractor for Jurisdiction 13 Overpaid Providers for Selected Outpatient Drugs (A-02-13-01011); New York Claimed Nonhospital-Based Continuing Day Treatment Services That Were Not in Compliance With Federal and State Requirements (A-02-12-01011)
06-30-2014: Not All Internal Controls Implemented by the Federal, California, and Connecticut Marketplaces Were Effective in Ensuring That Individuals Were Enrolled in Qualified Health Plans According to Federal Requirements (A-09-14-01000)
06-27-2014: Florida Made Some Payments for Pharmacy Items That Excluded Providers Had Prescribed (A-04-11-07024)
06-26-2014: South Carolina Did Not Always Accurately Report and Refund the Federal Share of Medicaid Collections for July 1, 2011, Through December 31, 2012 (A-04-13-00092)
06-25-2014: Medicare Compliance Review of Swedish Medical Center - First Hill (A-09-13-02048); Pennsylvania Complied With the Requirements of the Affordable Care Act in its Review of Cases of Credible Allegations of Medicaid Fraud (A-03-14-00202)
06-24-2014: California Claimed Medicaid Reimbursement for Some Nonemergency Medical Transportation Services in Los Angeles County That Did Not Comply With Federal and State Requirements (A-09-12-02083)
06-16-2014: Noninstitutional Providers in New York State Did Not Always Reconcile Account Records With Credit Balances and Report the Associated Medicaid Overpayments to the State Agency (A-02-11-01036)
06-13-2014: The Fraud Prevention System Identified Millions in Medicare Savings, but the Department Could Strengthen Savings Data by Improving Its Procedures (A-01-13-00510)
06-12-2014: Medicare Compliance Review of University of Washington Medical Center (A-09-13-02049)
06-10-2014: Trailblazer Health Enterprises Did Not Always Refer Medicare Cost Reports and Reconcile Outlier Payments as Required (A-07-10-02776)
06-06-2014: Inconsistencies in States' Reporting of the Federal Share of Medicaid Drug Rebates (A-06-13-00001); Medicare Compliance Reviews at Steward Health System Hospitals (A-01-14-00501)
06-05-2014: Medicare Compliance Review of University of Cincinnati Medical Center for Calendar Years 2010 and 2011 (A-05-12-00080)
06-04-2014: CMS's Reliance on California's Licensing Surveys of Nursing Homes Could Not Ensure the Quality of Care Provided to Medicare and Medicaid Beneficiaries (A-09-12-02037)
06-03-2014: CMS's Reliance on Illinois Licensure Requirements Could Not Ensure the Quality of Care Provided to Medicaid Hospice Beneficiaries (A-05-12-00028)
06-02-2014: The Centers for Medicare & Medicaid Services Paid Medicare Advantage Organizations for Services Provided to Beneficiaries Confined in Mental Health Facilities for Court-Ordered Purposes (A-07-13-06043); Average Manufacturer Price Determinations by Selected Drug Manufacturers Generally Were Consistent With Federal Requirements (A-06-13-00014)
05-28-2014: Pennsylvania's Gross Receipts Tax on Medicaid Managed Care Organizations Appears To Be an Impermissible Health-Care-Related Tax (A-03-13-00201); Medicare Inappropriately Paid Hospitals' Inpatient Claims Subject to the Postacute Care Transfer Policy (A-09-13-02036)
05-22-2014: Indiana Incorrectly Reported Expenditures on the Form CMS-64 at the Enhanced Federal Medical Assistance Percentage Rate (A-05-14-00011); Ohio Did Not Always Properly Claim Medicaid Reimbursement for Hospice Claims (A-05-12-00087)
05-21-2014: Blue Cross Blue Shield Association Did Not Claim Some Allowable Medicare Postretirement Benefit Costs for Fiscal Years 2002 Through 2010 (A-07-14-00434); Florida Medicaid Overpaid Hospitals for Some Inpatient Services That Medicare Paid (A-04-12-06158)
05-20-2014: Acute-Care Hospitals in Texas Did Not Always Reconcile Invoice Records With Credit Balances and Refund to the State Agency the Associated Medicaid Overpayments (A-06-11-00060)
05-08-2014: The Medicare Contractor for Jurisdiction 9 Overpaid Providers for Selected Outpatient Drugs (A-04-13-07038)
05-06-2014: Mount Sinai Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00028); Morristown Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00036); New York Claimed Unallowable Room-and-Board Costs Under Its Developmental Disabilities Waiver Program (A-02-12-01031)
05-02-2014: The Medicare Contractors for Jurisdiction H Overpaid Providers for Selected Outpatient Drugs (A-06-13-00010); Medicare Compliance Review of Robert Packer Hospital for Calendar Years 2009 Through 2011 (A-03-12-00003)
04-30-2014: Compliance Review of Woburn Dialysis (A-01-12-00516); Idaho Did Not Bill Manufacturers for Rebates for Some Medicaid Physician-Administered Drugs (A-09-12-02079); Medicare Compliance Review of Princeton Baptist Medical Center for Calendar Years 2010 and 2011 (A-04-12-00084)
04-25-2014: Highmark Medicare Services, Inc., Understated Its Allocable Nonqualified Defined-Benefit Plan Pension Costs for Calendar Years 2008 Through 2011 (A-07-13-00431); Highmark Medicare Services, Inc., Did Not Claim Some Allowable Nonqualified Defined-Benefit Plan Pension Costs for Fiscal Years 2003 Through 2009 (A-07-13-00430); Highmark Medicare Services, Inc., Overstated Its Nonqualified Defined-Benefit Plan Medicare Segment Pension Assets and Overstated the Medicare Segment Excess Pension Liabilities as of January 1, 2012 (A-07-13-00429)
04-24-2014: Oregon Claimed Unallowable Federal Medicaid Reimbursement by Not Billing Manufacturers for Rebates for Some Physician-Administered Drugs (A-09-12-02080)
04-23-2014: Medicare Compliance Review of Duke University Hospital for the Period January 1, 2011, Through September 30, 2012 (A-04-13-04012); Medicare Improperly Paid Medicare Advantage Organizations Millions of Dollars for Unlawfully Present Beneficiaries for 2010 Through 2012 (A-07-13-01125)
04-22-2014: Georgia Did Not Always Accurately Report and Refund the Federal Share of Medicaid Collections for Calendar Years 2008 Through 2011 (A-04-12-00085)
04-17-2014: The Medicare Contractors for Jurisdiction 6 Overpaid Providers for Selected Outpatient Drugs (A-06-13-00013)
04-16-2014: Medicare and Beneficiaries Could Save Billions If CMS Reduces Hospital Outpatient Department Payment Rates for Ambulatory Surgical Center-Approved Procedures to Ambulatory Surgical Center Payment Rates (A-05-12-00020)
04-15-2014: Medicare Compliance Review of Sutter Medical Center, Sacramento (A-09-13-02024); Medicare Compliance Review of Massachusetts General Hospital for Calendar Years 2010 and 2011 (A-01-12-00520)
04-10-2014: Maryland Underreported the Federal Share of Medicaid Overpayment Collections (A-03-11-00208)
04-08-2014: The Medicare Contractor for Jurisdiction 10 Overpaid Providers for Selected Outpatient Drugs (A-04-13-00090)
04-07-2014: Colorado Claimed Unallowable Medicaid Inpatient Supplemental Payments (A-07-13-04206); Medicare Improperly Paid Providers Millions of Dollars for Entitlement-Terminated Beneficiaries Who Received Services During 2010 Through 2012 (A-07-13-01127); CMS Generally Met Requirements in the Durable Medical Equipment Competitive Bidding Round 1 Rebid Program (A-05-12-00067)
04-03-2014: Oakwood Hospital and Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00032)
03-27-2014: New Jersey Claimed Excessive Medicaid Disproportionate Share Hospital Payments to Four Hospitals (A-02-10-01042)
03-26-2014: Highmark Medicare Services, Inc., Overstated Its Allocable Pension Costs for Calendar Years 2008 Through 2011 (A-07-13-00416); Highmark Medicare Services, Inc., Claimed Some Unallowable Medicare Pension Costs for Fiscal Years 2003 Through 2009 (A-07-13-00415); Highmark Medicare Services, Inc., Understated Its Medicare Segment Pension Assets and Understated the Medicare Segment Excess Pension Liabilities as of January 1, 2012 (A-07-13-00414)
03-24-2014: The California Medicaid Program Could Significantly Lower Payment Rates for Selected Durable Medical Equipment (A-09-13-02028)
03-21-2014: Weaknesses in Idaho's Information System General Controls Over Its Medicaid Claims Processing System Increase Vulnerabilities (A-09-12-03009)
03-18-2014: Medicare Contractors for Jurisdiction 8 Overpaid Providers for Selected Outpatient Drugs (A-05-13-00012); Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Allocable Postretirement Benefit Costs and Overstated Its Other Segment Allocable Postretirement Benefit Costs for Calendar Years 2006 Through 2010 (A-07-13-00422); Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Postretirement Benefit Costs for Fiscal Years 2006 Through 2010 (A-07-13-00421); Noridian Healthcare Solutions, LLC, Understated Its Medicare Segment Postretirement Benefit Assets as of January 1, 2011 (A-07-13-00420); State Medicaid Agencies Can Significantly Reduce Medicaid Costs for Diabetic Test Strips (A-05-13-00033)
03-17-2014: Medicare Compliance Review of Bryan Medical Center for Calendar Years 2010 and 2011 (A-07-12-05036)
03-14-2014: The Medicare Contractor for Jurisdiction 5 Overpaid Providers for Selected Outpatient Drugs (A-07-13-04201); Medicare Contractors for Jurisdiction 15 Overpaid Providers for Selected Outpatient Drugs (A-05-13-00013)
03-12-2014: CMS Did Not Always Correctly Make Clinic Visit Payments to Hospitals (A-04-12-06154)
03-11-2014: Medicaid Rates for Residential Habilitation Services Provided at New York State-Operated Residences Are Excessive (A-02-13-01008); Medicare Often Made Overpayments to New England Home Health Agencies for Claims Without Required Outcome and Assessment Information Set Data for Calendar Year 2010 (A-01-12-00508)
03-07-2014: Medicare Compliance Reviews at Hospitals in Christus Health System (A-06-14-00027)
03-06-2014: Michigan Claimed Improper Medicaid Reimbursement for Some Medicare Part B Premiums (A-05-12-00035)
03-05-2014: University Hospitals Case Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00031); Maine Did Not Always Claim Federal Medicaid Reimbursement for Clinical Diagnostic Laboratory Services in Accordance With Requirements (A-01-13-00005); High-Risk Security Vulnerabilities Identified During Reviews of Information Technology General Controls at State Medicaid Agencies (A-07-14-00433)
03-04-2014: Results of Reviews at Three Suppliers of Diabetic Testing Supplies (A-09-13-02032); Butler Memorial Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00014); Medicare Compliance Review of Nebraska Medical Center for Calendar Years 2010 and 2011 (A-07-12-05037)
02-25-2014: Medicare Compliance Review of Christus Santa Rosa Hospital for the Period January 1, 2010, Through June 30, 2012 (A-06-12-00068); Medicare Compliance Review of Christus Hospital - St. Elizabeth for the Period January 1, 2010, Through June 30, 2012 (A-06-13-00020); Medicare Compliance Review of Christus St. Frances Cabrini Hospital for the Period January 1, 2010, Through June 30, 2012 (A-06-13-00019)
02-20-2014: WellSpan York Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00015)
02-18-2014: Ben Taub Hospital Claimed Unallowable Medicare Reimbursement for Hospital Outpatient Dental Services (A-06-13-00004)
02-12-2014: Medicare Compliance Review of Good Samaritan Medical Center (A-01-13-00501)
02-11-2014: Palmetto Health Baptist Hospital Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00029)
02-07-2014: South Carolina Medicaid Overpaid Hospitals for Some Inpatient Services That Medicare Paid (A-04-11-06145)
02-06-2014: Compliance Review of Lowell General Hospital's Methuen Dialysis Facility (A-01-12-00517); The Medicare Contractors for Jurisdiction 12 Overpaid Providers for Selected Outpatient Drugs (A-03-13-00012); The Medicare Contractors for Jurisdiction 11 Overpaid Providers for Selected Outpatient Drugs (A-03-13-00011); Medicare Compliance Review of UMass Memorial Medical Center for Calendar Years 2010 and 2011 (A-01-13-00503)
02-05-2014: Kentucky Did Not Pay Some Line Items on Medicaid Claims in Accordance With Its Medicaid National Correct Coding Initiative Methodologies (A-04-13-06166)
01-29-2014: Medicare Compliance Review of Baylor All Saints Medical Center at Fort Worth for Calendar Years 2010 and 2011 (A-06-12-00030)
01-28-2014: New York State Made Unallowable Medicaid Fee-for-Service Payments for Beneficiaries Also Enrolled in Medicaid Managed Care (A-02-12-01007); Missouri Did Not Always Correctly Claim Costs for Medicaid Family Planning Drugs for Calendar Years 2009 and 2010 (A-07-12-01118); Christus Saint Vincent Regional Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00035)
01-27-2014: The Medicare Contractors for Jurisdiction E Overpaid Providers for Selected Outpatient Drugs (A-09-13-02009); Medicare Improperly Paid Millions of Dollars for Prescription Drugs Provided to Incarcerated Beneficiaries During 2006 Through 2010 (A-07-12-06035); The Medicare Contractor for Jurisdiction F Overpaid Providers for Selected Outpatient Drugs (A-09-13-02003)
01-23-2014: Mercy Medical Center Incorrectly Billed Medicare Inpatient Claims With Kwashiorkor (A-03-13-00033)
01-16-2014: Utah Did Not Properly Pay Some Medicare Deductibles and Coinsurance (A-07-13-03191)
01-15-2014: Medicare Compliance Review of Medical University of South Carolina for the Period January 1, 2011, Through June 30, 2012 (A-04-13-03075); TrailBlazer Claimed Medicare Part B Administrative Costs in Accordance With Federal Requirements (A-06-13-00016)
01-13-2014: The Minnesota Medicaid Program Could Significantly Lower Payment Rates for Selected Durable Medical Equipment and Supplies (A-05-13-00015)
01-10-2014: Jersey City, New Jersey, Did Not Always Comply With Early Retiree Reinsurance Program Requirements (A-05-12-00039)
01-09-2014: Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2011 (A-18-13-30100)
01-07-2014: Medicare Compliance Review of Memorial Hospital for Calendar Years 2010 and 2011 (A-07-13-01124)
01-06-2014: Medicare Compliance Review of Morton Hospital for Calendar Years 2010 and 2011 (A-01-13-00500)

2013

12-31-2013: Medicare Could Have Saved Millions if Organ Procurement Organizations Had Correctly Reported Procurement of Double Lungs as Two Organs (A-09-12-02085)
12-30-2013: Medicare Payments for Vacuum Erection Systems Are More Than Twice as Much as the Amounts Paid for the Same or Similar Devices by Non-Medicare Payers (A-07-12-05024)
12-24-2013: Most of New Jersey's Claims for Medicaid Supported Employment Services Were Unallowable (A-02-12-01009)
12-23-2013: CMS Should Improve Oversight for the Transfer of True Out-of-Pocket Costs Between Part D Plans (A-05-12-00053)
12-20-2013: Maryland Withdrew Excessive Federal Medicaid Funds for Fiscal Years 2009 Through 2011 (A-06-12-00051)
12-19-2013: Reviews of Clinicians Associated With High Cumulative Payments Could Improve Medicare Program Integrity Efforts (A-01-11-00511)
12-18-2013: Medicare Compliance Review of Heartland Regional Medical Center for Calendar Years 2010 and 2011 (A-07-12-01120)
12-17-2013: Texas' Experience Rebate Provision in Managed Care Contracts Were Administered in Accordance with Federal, State, and Contractual Requirements (A-06-13-00002)
12-16-2013: Noridian Healthcare Solutions, LLC, Claimed Some Unallowable Medicare Pension Costs for Fiscal Years 2006 Through 2010 (A-07-13-00418); Noridian Healthcare Solutions, LLC, Overstated Its Allocable Pension Costs for Calendar Years 2006 Through 2010 (A-07-13-00419)
12-13-2013: Review of Douglas Consulting and Computer Services, Inc., Claimed Costs for Calendar Years 2008 Through 2011 (A-03-12-03302)
12-12-2013: Kentucky Did Not Correctly Calculate Payment Rates for Private Facilities or Report Cost Settlement Adjustments to CMS (A-04-12-08018); Colorado Did Not Properly Pay Some Medicare Part B Deductibles and Coinsurance (A-07-13-03189)
12-04-2013: Georgia Did Not Pay Some Line Items on Medicaid Claims in Accordance With Its Medicaid National Correct Coding Initiative Methodologies (A-04-12-06159); Hawaii Did Not Comply With Some Provisions of the QUEST Expanded Medicaid Demonstration Project When Determining Eligibility for Federal Reimbursement of Uncompensated Care Costs (A-09-12-02084)
12-03-2013: Medicare Compliance Review of St. Vincent's Medical Center for Calendar Years 2009 and 2010 (A-04-12-08013); Medicare Compliance Review of St. Elizabeth's Medical Center for Calendar Years 2010 and 2011 (A-01-12-00528)
11-26-2013: Noridian Healthcare Solutions, LLC, Inappropriately Paid Hospitals' Medicare Claims Subject to the Postacute Care Transfer Policy in Jurisdiction 2 (A-09-13-02035)
11-27-2013: Medicare Contractors Nationwide Overpaid Millions to Providers for Full Vials of Herceptin (A-05-13-00024)
11-26-2013: Maryland Claimed Unallowable Federal Reimbursement for Some Medicaid Physician-Administered Drugs (A-03-12-00200)
11-25-2013: Medicare Compliance Review of JFK Medical Center for Calendar Years 2009 and 2010 (A-04-12-07032)
11-20-2013: Medicare Compliance Review of Mercy Medical Center in Mason City for Calendar Years 2010 and 2011 (A-07-12-05030); Diep Chiropractic Wellness, Inc., Received Unallowable Medicare Payments for Chiropractic Services (A-09-12-02072); New York Claimed Some Unallowable Costs for Assistive Technology Services Under the State's Developmental Disabilities Waiver Program (A-02-10-01039)
11-19-2013: Medicare Compliance Review of Mercy Medical Center in Des Moines for Calendar Years 2009 and 2010 (A-07-12-05028)
11-18-2013: Parkland Health and Hospital System Claimed Unallowable Medicare Reimbursement for Hospital Outpatient Dental Services (A-06-13-00003); Medicare Compliance Review of University of Utah Hospital for Calendar Years 2009 and 2010 (A-07-12-01107)
11-12-2013: Oregon Generally Claimed Federal Medicaid Reimbursement for Money Follows the Person Program Expenditures in Compliance With Federal and State Requirements but Internal Controls Should Be Strengthened (A-09-12-02049)
10-30-2013: Medicare Improperly Paid Millions of Dollars for Prescription Drugs Provided to Unlawfully Present Beneficiaries During 2009 Through 2011 (A-07-12-06038)
10-29-2013: National Government Services, Inc., Understated Its Medicare Segment Pension Assets as of January 1, 2010 (A-07-13-00408); National Government Services, Inc., Claimed Some Unallowable Medicare Pension Costs for Fiscal Years 2003 Through 2006 (A-07-13-00409)
10-25-2013: National Government Services, Inc., Paid Unallowable Lower Limb Prosthetics Claims (A-07-13-05039)
10-23-2013: Medicare Compliance Review of Mary Washington Hospital for Calendar Years 2009 Through 2011 (A-03-12-06106)
10-21-2013: Arkansas Properly Reported the Affordable Care Act Portion of Medicaid Drug Rebates (A-06-13-00034); New York Improperly Claimed Medicaid Reimbursement for Orthodontic Services to Beneficiaries in New York City (A-02-11-01003)
10-17-2013: Colorado Improperly Claimed Some Medicaid Costs for Hospice Services Provided by Evercare Hospice & Palliative Care (A-07-13-04204)
10-10-2013: Medicare Compliance Review Of MedStar Washington Hospital Center (A-03-12-06103)
10-04-2013: HealthNow New York, Inc., Did Not Claim Some Allowable Medicare Part B Pension Costs for Fiscal Years 2007 Through 2009 (A-07-13-00426); HealthNow New York, Inc., Understated Its Medicare Part B Segment Pension Assets and Understated Medicare's Share of the Medicare Segment Excess Pension Liabilities as of January 1, 2009 (A-07-13-00425)
09-30-2013: Medicare Compliance Review of University of Miami Hospital (A-04-12-07033)
09-27-2013: Indiana Claimed Medicaid Reimbursement for High-Dollar Inpatient Services That Were Unallowable (A-05-11-00040)
09-26-2013: Medicare Compliance Review of UPMC Presbyterian Shadyside for Calendar Years 2008 Through 2011 (A-03-12-06105)
09-25-2013: Medicare Compliance Review of University of Wisconsin Hospital and Clinics for Calendar Years 2008 Through 2010 (A-05-12-00030)
09-20-2013: New York State Improperly Claimed Medicaid Reimbursement for Some Home Health Services Claims Submitted by Certified Home Health Agencies (A-02-11-01008)
09-19-2013: Oklahoma Complied With the Federal Medicaid Requirements for Billing Manufacturers for Rebates for Physician-Administered Drugs (A-06-12-00059)
09-17-2013: Medicare Incorrectly Paid Hospitals for Beneficiaries Who Had Not Received 96 or More Hours of Mechanical Ventilation (A-09-12-02066); Bravo Health Pennsylvania, Inc. (Contract H3949), Submitted Many Diagnoses to the Centers for Medicare & Medicaid Services That Did Not Comply With Federal Requirements for Calendar Year 2007 (A-03-09-00003)
09-16-2013: Illinois Did Not Always Properly Claim Medicaid Reimbursement for Hospice Claims (A-05-12-00029)
09-11-2013: Wisconsin Improperly Claimed Federal Medicaid Reimbursement for Most Residential Care Center Payments (A-05-07-00036); Medicaid Hospice General Inpatient Payments to Home and Hospice Care of Rhode Island Did Not Always Meet Federal and State Requirements (A-01-13-00002); Tallahassee Memorial HealthCare, Inc., Submitted Incomplete Quality Measure Data to CMS (A-04-11-08002)
09-09-2013: Maryland Claimed Costs for Unallowable Room and Board and Other Residential Habilitation Costs Under Its Community Pathways Waiver Program (A-03-12-00203)
09-05-2013: Medicare Compliance Review of Sanford Medical Center in Fargo for Calendar Years 2010 and 2011 (A-07-12-05031); New Jersey Medicaid Program Could Achieve Savings by Reducing Home Blood-Glucose Test Strip Prices (A-02-12-01010); New York Claimed Hospital-Based Continuing Day Treatment Services That Were Not in Compliance With Federal and State Requirements (A-02-11-01038)
08-29-2013: Salary and Nonsalary Costs Claimed by the University of Texas Southwestern Medical Center Were Allowable (A-06-11-00018)
08-27-2013: Medicare Compliance Review of St. Joseph Regional Health Center for Calendar Years 2009 and 2010 (A-06-12-00029); Alabama Received Millions in Unallowable Performance Bonus Payments Under the Children's Health Insurance Program Reauthorization Act (A-04-12-08014)
08-21-2013: Medicare Compliance Review of Southcoast Hospitals Group for Calendar Years 2010 and 2011 (A-01-12-00523); Medicare Compliance Review of Tulane Medical Center of New Orleans for Calendar Years 2010 and 2011 (A-06-12-00034)
08-16-2013: Durable Medical Equipment Claims Paid by Noridian Healthcare Solutions, LLC, Did Not Always Meet the Requirements of the Local Coverage Determination for Lower Limb Prostheses (A-07-12-05035)
08-09-2013: Durable Medical Equipment Claims Paid by National Heritage Insurance Company, Inc., Did Not Always Meet the Requirements of the Local Coverage Determination for Lower Limb Prostheses (A-07-13-05040)
08-08-2013: Washington State Claimed a Small Amount of Unallowable Medicaid Reimbursement for Home Health Services That Exceeded the Maximum Allowable Number of Reimbursable Visits (A-09-12-02056); Palmetto GBA Claimed Substantially Allowable Costs on Its Part B Final Administrative Cost Proposals for Fiscal Years 2010 and 2011 (A-04-13-04008)
08-07-2013: New Jersey Did Not Always Claim Medicaid Reimbursement for Medicare Part B Premiums in Accordance with Federal Requirements (A-02-10-01025); New York Complied With Federal Requirements to Report Medicaid Overpayment Collections for the Quarter Ended September 30, 2011 (A-02-12-01020)
08-05-2013: Medicare Could Save Millions by Strengthening Billing Requirements for Canceled Elective Surgeries (A-01-12-00509)
08-02-2013: National Government Services Claimed Allowable Administrative Costs for Fiscal Years 2008 and 2009 under Medicare Contract 00130 (A-05-12-00037)
08-02-2013: Observations Noted During the OIG Review of CMS's Implementation of the Health Insurance Exchange-Data Services Hub (A-18-13-30070)
07-30-2013: The Centers for Medicare & Medicaid Services Awarded Consumer Operated and Oriented Plan Program Loans in Accordance With Federal Requirements, and Continued Oversight Is Needed (A-05-12-00043)
07-24-2013: Medicare Compliance Review of Community Medical Center for Calendar Years 2010 and 2011 (A-07-12-01119)
07-16-2013: Medicare Compliance Review of the Hospital of the University of Pennsylvania for Calendar Years 2008 Through 2011 (A-03-12-06104)
07-12-2013: CGS Administrators, LLC, Paid Unallowable Lower Limb Prosthetics Claims (A-06-12-00055)
07-11-2013: Medicare Compliance Review of University of Kansas Hospital for Calendar Years 2009 and 2010 (A-07-11-01105); Medicare Compliance Review of Via Christi Hospital for Calendar Years 2009 and 2010 (A-07-11-01099)
07-05-2013: Wing Memorial Hospital Did Not Always Bill Correctly for Evaluation and Management Services Related to Diagnostic or Therapeutic Procedures and Supartz Injections (A-01-12-00519)
07-02-2013: The New York State Manufacturer Rebate Program Significantly Reduced Medicaid Costs for Home Blood-Glucose Test Strips But Could Achieve Additional Reductions (A-02-11-01042); Kentucky Substantially Met Money Follows the Person Program Requirements (A-04-12-06152)
07-01-2013: Noninstitutional Providers in California Did Not Always Reconcile Invoice Records With Credit Balances and Refund to the State Agency the Associated Medicaid Overpayments (A-09-12-02047)
06-25-2013: Medicare Part B and Beneficiaries Paid for Xolair That Jurisdiction 14 Physicians Discarded Without Documentation (A-01-12-00518); Massachusetts Medicaid Payments to Healthbridge Management Did Not Always Comply With Federal and State Requirements (A-01-13-00001); Missouri Claimed Unallowable Medicaid Payments for Individuals With Intellectual and Developmental Disabilities in Intermediate Care Facilities (A-07-12-03180); California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Drugs and Supplies Provided in San Diego County (A-09-12-02077); Medicare Compliance Review of Hospital Español Auxilio Mutuo De Puerto Rico, Inc., For Calendar Years 2010 and 2011 (A-02-12-01026)
06-21-2013: Meritus Medical Center Refunded Overpayments for Physician Claims With Place-of-Service Coding Errors For 2009 Through 2012 (A-01-12-00531); Missouri Improperly Claimed Federal Reimbursement for Most Reviewed Medicaid Inpatient Psychiatric Hospital Service and Disproportionate Share Hospital Payments to Hawthorn Children's Psychiatric Hospital (A-05-12-00050); Indiana Improperly Claimed Federal Reimbursement for All Reviewed Medicaid Inpatient Psychiatric Hospital Service Payments to Evansville State Hospital (A-05-12-00041)
06-20-2013: Baptist Medical Center South Complied With Most Medicare Requirements for Billing Inpatient and Outpatient Services for Calendar Years 2009 and 2010 (A-04-12-00083); Medicare Compliance Followup Review of Tufts Medical Center (A-01-12-00527)
06-17-2013: CGS Administrators, LLC Made Payments for Therapeutic Shoes Furnished to Medicare Beneficiaries in Puerto Rico That Generally Did Not Comply With Federal Requirements (A-02-11-01001)
06-12-2013: National Government Services Claimed Allowable Administrative Costs for Fiscal Years 2008 and 2009 under Medicare Contract 00450 (A-05-11-00110); Missouri Did Not Always Correctly Claim Costs for Medicaid Family Planning Sterilization Procedures for Calendar Years 2009 and 2010 (A-07-12-01117)
06-11-2013: Medicare Compliance Review of Community Regional Medical Center (A-09-12-02071)
06-10-2013: Spectrum Rehabilitation, LLC, Claimed Unallowable Medicare Part B Reimbursement for Outpatient Therapy Services (A-02-11-01044)
06-07-2013: Wisconsin Claimed Medicaid Reimbursement for High-Dollar Inpatient Services That Were Unallowable (A-05-11-00037); Anthem Health Plans of New Hampshire, Inc., Understated Its Medicare Segment Pension Assets as of January 1, 2006 (A-07-13-00406); Anthem Health Plans of New Hampshire, Inc., Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2003 Through 2005 (A-07-13-00407); Quality Software Services, Inc., Had Not Implemented Universal Serial Bus Device and Port Controls. (A-04-12-05045)
06-06-2013: Anthem Health Plans of Maine, Inc., Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2003 Through 2005 (A-07-13-00405); Anthem Health Plans of Maine, Inc., Overstated Its Medicare Segment Pension Assets as of January 1, 2006 (A-07-13-00404); Blue Cross Blue Shield of Georgia Did Not Claim Some Allowable Medicare Pension Costs for Fiscal Years 2006 Through 2009 (A-07-12-00398); Blue Cross Blue Shield of Georgia Overstated Its Medicare Segment Pension Assets and Understated Medicare's Share of the Excess Liabilities as of May 31, 2009 (A-07-12-00397); Medicare Payments to Connecticut Physicians for Full Vials of Herceptin Were Generally Correct (A-01-12-00515)
06-05-2013: Medicare Compliance Review of Aibonito Mennonite General Hospital, Inc., for Calendar Years 2010 and 2011 (A-02-12-01032); Medicare Payments to Jurisdiction 14 Physicians for Full Vials of Herceptin Were Generally Correct (A-01-12-00514)
06-04-2013: Medicare Compliance Review of the Brooklyn Hospital Center for Calendar Years 2010 and 2011 (A-02-12-01021)
05-30-2013: Maryland Generally Complied With Requirements for Medicaid Payments Made to Multi-Medical Center for Nursing Facility Services (A-03-11-00151); Indiana Improperly Claimed Federal Reimbursement for Most Medicaid Inpatient Psychiatric Hospital Service and Disproportionate Share Hospital Payments to Evansville Psychiatric Children's Center (A-05-12-00040)
05-29-2013: Medicare Compliance Followup Review of Boston Medical Center (A-01-12-00524); Palmetto GBA, LLC, Inappropriately Paid Hospitals' Medicare Claims Subject to the Postacute Care Transfer Policy in Jurisdiction 1 (A-09-12-02038)
05-28-2013: Medicare Could Save Millions by Implementing a Hospital Transfer Payment Policy for Early Discharges to Hospice Care (A-01-12-00507)
05-22-2013: Florida Generally Ensured That Providers Complied With Selected State Durable Medical Equipment Enrollment Requirements (A-04-12-07034); The Medicare Contractor's Payments to Providers in Jurisdiction 13 for Full Vials of Herceptin Were Often Incorrect (A-02-12-01003)
05-21-2013: New York's Claims for Medicaid Services Provided Under Its Traumatic Brain Injury Waiver Program Did Not Comply With Certain Federal and State Requirements (A-02-10-01043)
05-20-2013: Medicare Compliance Review of Rapid City Regional Hospital for Calendar Years 2010 and 2011 (A-07-12-05033)
05-16-2013: Medicare Compliance Review of Saint Thomas Hospital for Calendar Years 2009 and 2010 (A-04-12-03071)
05-15-2013: Medicare Compliance Review of Cedars-Sinai Medical Center for the Period January 1, 2008, Through June 30, 2011 (A-09-12-02048)
05-13-2013: National Government Services Claimed Allowable Administrative Costs for Fiscal Years 2008 and 2009 Under Medicare Contract 00630 (A-05-11-00084)
05-09-2013: Medicare and Beneficiaries Could Save Millions If Dialysis Payments Were Adjusted for Anemia Management Drug Utilization (A-01-12-00522)
05-07-2013: North Carolina Medicaid Overpaid Hospitals for Some Inpatient Services That Medicare Paid (A-04-11-06137)
05-06-2013: Illinois Significantly Reduced Medicaid Costs for Home Blood-Glucose Test Strips But Could Achieve Additional Reductions (A-05-12-00009)
05-01-2013: CIGNA Healthcare of Arizona, Inc. (Contract H0354), Submitted Many Diagnoses to the Centers for Medicare & Medicaid Services That Did Not Comply With Federal Requirements for Calendar Year 2007 (A-07-10-01082)
04-30-2013: The Ohio Medicaid Program Could Significantly Lower Payment Rates for Selected Durable Medical Equipment and Supplies (A-05-12-00038); Triple-S Salud Did Not Claim Some Allowable Pension Costs for Fiscal Years 2007 Through 2009 (A-07-12-00396); Triple-S Salud Understated Its Medicare Segment Assets and Overstated Medicare's Share of the Excess Liabilities as of March 1, 2009 (A-07-12-00395)
04-29-2013: Maine Improperly Claimed Medicaid Payments for School-Based Health Services Submitted by Portland School Department (A-01-11-00011); Connecticut Generally Implemented Recommendations From Prior Review of Medicaid Payments for Clinical Laboratory Services (A-01-12-00014)
04-24-2013: MedEnvios Healthcare, Inc., Submitted Claims for Diabetic Testing Supplies Without the KL Modifier in Accordance With Medicare Billing Requirements (A-09-12-02053)
04-23-2013: Hawaii Did Not Adequately Monitor Implementation of Some Risk-Sharing Contract Provisions for the QUEST Expanded Medicaid Managed Care Program (A-09-11-02054); Medicare Contractors' Payments Made to Providers in Jurisdiction 7 for Full Vials of Herceptin Were Often Incorrect (A-06-11-00068)
04-18-2013: Tennessee Incorrectly Reported Costs for Individuals With Intellectual and Developmental Disabilities (A-04-12-08016)
04-15-2013: New York State Made Unallowable Medicaid Managed Care Payments for Beneficiaries Assigned Multiple Medicaid Identification Numbers (A-02-11-01006); California Made Unallowable Medicaid Payments for Items and Services Furnished, Ordered, or Prescribed by Excluded Providers (A-09-11-02016); Impact on Medicare Program for Investment Income That Medicare Part D Plans Earned and Retained From Medicare Funds in 2009 (A-07-11-05017)
04-11-2013: Maryland Improperly Claimed Personal Care Services Provided Under Its Medicaid Home and Community-Based Services Waiver for Older Adults (A-03-11-00201)
04-04-2013: Medicare Compliance Review of Lahey Clinic for Calendar Years 2009 and 2010 (A-01-12-00502)
04-03-2013: Rhode Island's Managed Care Contract Settlements With Neighborhood Health Plan of Rhode Island Did Not Always Comply With Federal and State Requirements (A-01-12-00011); Medicare Compliance Review of Sanford USD [University of South Dakota] Medical Center in Sioux Falls for Calendar Years 2010 and 2011 (A-07-12-05032)
04-01-2013: Lower Limb Prosthetics Claims Paid to Ozark Prosthetics and Orthotics Were Not Always Supported by Adequate Documentation (A-07-12-05029)
03-28-2013: Most of HealthNow New York, Inc.'s Medicare Part B Severance and Termination Costs Were Allowable (A-02-11-01020); Florida Medicaid: Millions in Overpayments Not Refunded (A-04-11-08007)
03-26-2013: New York Improperly Claimed Medicaid Reimbursement for Family-Based Treatment Rehabilitation Services (A-02-10-01024)
03-20-2013: Medicare Compliance Review of North Shore Medical Center for Calendar Years 2009 and 2010 (A-01-12-00506)
03-19-2013: Oklahoma Improperly Claimed Federal Reimbursement for Most Reviewed Medicaid Inpatient Psychiatric Hospital Service and Disproportionate Share Hospital Payments to Children's Recovery Center (A-05-12-00052)
03-13-2013: Missouri Incorrectly Claimed Federal Reimbursement for Inpatient Claims With Sterilization and Delivery Procedures for Calendar Years 2009 and 2010 (A-07-12-01121); Group Health Incorporated Overstated Allocable Pension Costs for Plan Years 2007 and 2008 (A-07-12-00381)
03-12-2013: Palmetto GBA Claimed Substantially Allowable Costs on Its Part A Final Administrative Cost Proposals for Fiscal Years 2010 and 2011 (A-04-12-04027)
03-06-2013: Medicare Compliance Review of Somerset Hospital for Calendar Years 2009 Through 2011 (A-03-12-06107); Medicare Compliance Review of Saint Michael's Medical Center for the Period January 1, 2009, Through June 30, 2011 (A-02-12-01005); New Jersey's Medicaid Expenditure Claim Was Supported by Actual Recorded Expenditures (A-02-10-01013)
03-08-2013: Advanced Diabetes Supply Submitted Claims for Diabetic Testing Supplies Without the KL Modifier in Accordance With Medicare Billing Requirements (A-09-12-02035)
03-07-2013: Florida Claimed Some Medicaid Administrative Costs That Did Not Comply With Program Requirements (A-04-10-00076)
03-06-2013: Missouri Claimed Federal Reimbursement for Unallowable Personal Care Services Claims Submitted by The Whole Person, Incorporated (A-07-11-03170)
02-28-2013: Blue Cross Blue Shield Association Did Not Claim Some Allowable Pension Costs For Fiscal Years 1997 Through 2010 (A-07-13-00411); Blue Cross Blue Shield Association Understated the Medicare Segment Pension Assets for the Period of January 1, 1997, to January 1, 2011 (A-07-13-00410); Postretirement Benefit Costs Claimed by United Government Services for October 1, 2001, Through December 31, 2006, Were Reasonable and Allowable (A-07-12-00399)
02-21-2013: Norwalk Hospital Did Not Comply With Medicare Inpatient Rehabilitation Facility Documentation Requirements (A-01-11-00531)
02-19-2013: The Medicare Contractor's Payments in 26 States from the WPS Legacy Workload for Full Vials of Herceptin Were Often Incorrect (A-05-11-00114); The Centers for Medicare & Medicaid Services Collected the Majority of Medicaid Overpayments but Millions Remain Uncollected (A-05-11-00071)
02-13-2013: Medicare Contractors' Payments in Jurisdiction 1 for Full Vials of Herceptin Were Often Incorrect (A-09-12-02069)
02-08-2013: Indiana Improperly Claimed Federal Reimbursement for All Reviewed Medicaid Inpatient Psychiatric Hospital Service Payments to Logansport State Hospital (A-05-12-00042); Acute Care Hospitals in Georgia Did Not Always Reconcile Invoice Records With Credit Balances and Report the Associated Medicaid Overpayments to the State Agency (A-04-12-04021)
02-06-2013: TrailBlazer Mostly Claimed Medicare Part A Administrative Costs in Accordance With Federal Requirements (A-06-10-00108)
01-30-2013: Review of Louisiana Medicaid Personal Care Services Provided by Immaculate Heart of Mary-PCS Audit (A-06-09-00106); Blue Cross Blue Shield of Tennessee Overclaimed Postretirement Benefit Costs for Fiscal Years 1992 Through 2009 (A-07-12-00403); Nursing Facilities in Missouri Did Not Reconcile Invoice Records With Credit Balances and Report the Associated Medicaid Overpayments to the State Agency (A-07-11-03169)
01-28-2013: Massachusetts Medicaid Payments to Weymouth Health Care Center Did Not Always Comply With Federal and State Requirements (A-01-12-00016)
01-25-2013: The Medicare Contractors' Payments in Jurisdiction 10 for Full Vials of Herceptin Were Often Incorrect (A-04-12-03070); Massachusetts Medicaid Payments to Essex Park Rehabilitation and Nursing Center Did Not Always Comply With Federal and State Requirements (A-01-12-00015)
01-23-2013: Medicare Improperly Paid Providers Millions of Dollars for Incarcerated Beneficiaries Who Received Services During 2009 Through 2011 (A-07-12-01113); Medicare Improperly Paid Providers Millions of Dollars for Unlawfully Present Beneficiaries Who Received Services During 2009 Through 2011 (A-07-12-01116)
01-22-2013: Arizona Improperly Claimed Federal Reimbursement for Medicaid School-Based Administrative Costs (A-09-11-02020)
01-18-2013: Arkansas Inappropriately Received Medicaid Family Planning Funding for Federal Fiscal Years 2006 Through 2010 (A-06-11-00022)
01-17-2013: Arkansas Generally Supported Its Claim for Federal Medicaid Reimbursement (A-06-10-00098)
01-16-2013: Neighborhood Diabetes, Inc., Submitted Claims for Diabetic Testing Supplies Without the KL Modifier in Accordance With Medicare Billing Requirements (A-09-11-02073)
01-10-2013: Medicare Compliance Review of California Pacific Medical Center, Pacific Campus, for Calendar Years 2009 and 2010 (A-09-12-02027)
01-09-2013: Medicare Payments to New York Rehabilitative Services, LLC, for Lower Limb Prosthetic Services Generally Complied With Certain Federal Requirements (A-02-12-01002)
01-08-2013: Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2010 (A-18-12-30100)
01-07-2013: The Medicare Contractor's Payments to Providers in Jurisdiction 9 for Full Vials of Herceptin Were Often Incorrect (A-04-12-06146)

2012

12-31-2012: TrailBlazer Claimed Medicare Part B Administrative Costs in Accordance With Federal Requirements (A-06-10-00109)
12-27-2012: Medicare Compliance Review of Baton Rouge General Medical Center for Calendar Years 2009 and 2010 (A-06-11-00065); Lower Limb Prosthetics Claims Paid to Premier Prosthetics and Orthotics Were Not Always Supported by Adequate Documentation (A-07-12-05026)
12-21-2012: Medicare Contractors' Payments in Jurisdictions 15 to Providers for Full Vials of Herceptin Were Often Incorrect (A-05-12-00017)
12-20-2012: California Improperly Claimed Enhanced Federal Reimbursement for Medicaid Family Planning Services Provided in San Diego County (A-09-11-02040)
12-19-2012: The UAW Retiree Medical Benefits Trust Properly Claimed Early Retiree Reinsurance Program Reimbursements (A-05-11-00108); The Chicago Regional Council of Carpenters Welfare Fund Properly Claimed Early Retiree Reinsurance Program Reimbursements (A-05-11-00109)
12-17-2012: Pennsylvania Claimed Unallowable Medicaid Administrative Costs for the Regional Housing Coordinator Initiative (A-03-11-00210); The Department of Health and Human Services Has Implemented Predictive Analytics Technologies But Can Improve Its Reporting on Related Savings and Return on Investment (A-17-12-53000)
12-13-2012: The Medicare Contractor's Payments in Jurisdictions 6 and 8 for Full Vials of Herceptin Were Often Incorrect (A-05-11-00112); Review of Medicare Outpatient Billing for Selected Drugs at St. Joseph Hospital (A-09-12-02039); Medicare Compliance Review of New York University Langone Medical Center for the Period July 1, 2008, Through December 31, 2010 (A-02-11-01043)
12-12-2012: Providers Did Not Correctly Bill Medicare Part B for the Oral Form of the Drug Emend (A-07-11-04181)
12-10-2012: Medicare Compliance Review of Hoag Memorial Hospital Presbyterian for Calendar Years 2008 Through 2011 (A-09-12-02012)
12-05-2012: Medicare Compliance Review of Rhode Island Hospital for Calendar Years 2010 and 2011 (A-01-12-00510); Medicare Compliance Review of Hartford Hospital for Calendar Years 2009 and 2010 (A-01-11-00533); Medical Services of America Did Not Always Have Required Documentation on File to Support Its Medicare Claims (A-04-11-04010)
12-04-2012: Review of Medicare Outpatient Billing for Selected Drugs at St. Luke's Boise Medical Center (A-09-12-02043); Review of Medicare Outpatient Billing for Selected Drugs at Sky Lakes Medical Center (A-09-12-02061)
12-03-2012: Medicare Contractors' Payments Made to Providers Currently Assigned to Jurisdiction 4 for Full Vials of Herceptin Were Often Incorrect (A-06-12-00001)
11-30-2012: Risk Adjustment Data Validation of Payments Made to PacifiCare of California for Calendar Year 2007 (Contract Number H0543) (A-09-09-00045); Massachusetts Generally Implemented Recommendations From Prior Review of Claims for Hospital Outpatient Clinical Laboratory Services (A-01-12-00005); Medicare Compliance Review of Tufts Medical Center for Calendar Years 2009 and 2010 (A-01-12-00503)
11-29-2012: New York Improperly Claimed Medicaid Reimbursement for Some Home Health Services Claims Submitted by Certified Home Health Agencies in New York City (A-02-10-01022)
11-27-2012: Most of Pinnacle's Medicare Part B Administrative Costs Reported for Fiscal Years 2008 and 2009 Were Allowable (A-06-11-00045)
11-21-2012: Review of Medicare Outpatient Billing for Selected Drugs at University of California, Irvine, Medical Center (A-09-12-02063); Review of Medicare Outpatient Billing for a Selected Drug at Arroyo Grande Community Hospital (A-09-12-02064)
11-20-2012: Almost All of Pinnacle's Medicare Part A Administrative Costs Reported for Fiscal Years 2008 and 2009 Were Allowable (A-06-11-00044); Iowa Did Not Properly Pay Some Medicare Part A and Part B Deductibles and Coinsurance (A-07-12-03178); The Medicare Contractor's Payments in Jurisdiction 3 for Full Vials of Herceptin Were Often Incorrect (A-07-12-04186)
11-15-2012: LifeCenter Northwest Did Not Fully Comply With Medicare Requirements for Reporting Organ Statistics in Its Fiscal Year 2009 Medicare Cost Report (A-09-11-02039)
11-14-2012: The Emergency Medical Services Authority of Oklahoma City Billed and Was Paid for Advanced Life Support Transports That Were Not Medically Necessary (A-06-11-00050); The New Jersey Department of Human Services Claimed Medicaid Disproportionate Share Hospital Payments to Five Hospitals That Did Not Meet Federal Eligibility Requirements (A-02-09-01017)
11-13-2012: Medicare Made Payments to United Healthcare of Wisconsin, Inc. Under Part D for Drugs That Were Already Covered Under Part C (A-05-11-00051); Medicare Compliance Review of the University of Iowa Hospital for Calendar Years 2009 and 2010 (A-07-12-05023)
11-08-2012: Noninstitutional Providers in North Carolina Did Not Reconcile Invoice Records With Credit Balances and Report the Associated Medicaid Overpayments to the State Agency (A-04-11-04016); Review of Medicare Outpatient Billing for a Selected Drug at Community Hospital Long Beach Memorial (A-09-12-02065); Review of Medicare Outpatient Billing for a Selected Drug at Banner Baywood Medical Center (A-09-12-02062)
11-06-2012: The Medicare Contractor's Payments in Jurisdiction 2 for Full Vials of Herceptin Were Often Incorrect (A-09-12-02003)
11-01-2012: Blue Cross Blue Shield of Tennessee Did Not Claim Some Allowable Restoration Supplemental Executive Retirement Plan Costs for Fiscal Years 2008 and 2009 (A-07-12-00394)
10-30-2012: Review of Medicare Outpatient Billing for Selected Drugs at Doctors Medical Center (A-09-12-02041); Review of Medicare Outpatient Billing for Selected Drugs at Oroville Hospital (A-09-12-02040)
10-25-2012: Review of Medicare Part D Prescription Drug Event Data for Schedule II Drugs at Humana Insurance Company (A-09-12-02031)
10-23-2012: The Medicare Contractor's Payments in Jurisdiction 5 for Full Vials of Herceptin Were Often Incorrect (A-07-12-04187); Review of Medicare Outpatient Billing for Selected Drugs at Swedish Medical Center - First Hill (A-09-12-02042); Review of Medicare Outpatient Billing for Selected Drugs at Ronald Reagan UCLA Medical Center (A-09-12-02050)
10-18-2012: Medicare Compliance Review of Intermountain Medical Center for Calendar Years 2009 and 2010 (A-07-12-01108); Medicare Compliance Review of North Kansas City Hospital for Calendar Years 2009 and 2010 (A-07-12-01115)
10-17-2012: Medicare Compliance Review of Wing Memorial Hospital for Calendar Years 2009 and 2010 (A-01-11-00536)
10-15-2012: Medicare Compliance Review of The University of Alabama at Birmingham Hospital for Calendar Years 2009 and 2010 (A-04-11-00080)
10-10-2012: New Hampshire Did Not Always Correctly Claim Medicaid Payments for School-Based Transportation Services (A-01-11-00008)
10-05-2012: Texas Did Not Always Comply With Federal and State Requirements Regarding the Medicare Buy-In Program (A-06-10-00070); Risk Adjustment Data Validation of Payments Made to Excellus Health Plan, Inc., for Calendar Year 2007 (Contract Number H3351) (A-02-09-01014)
10-04-2012: Massachusetts Medicaid Payments to Millbury Health Care Center Did Not Always Comply With Federal and State Requirements (A-01-12-00010)
10-03-2012: West Virginia Improperly Claimed Some Personal Care Services Under Its Medicaid State Plan (A-03-11-00204)
09-27-2012: Maryland Claimed Medicaid Administrative Costs for Unallowable Remedial and Training Services for the Maryland Poison Center (A-03-12-00204)
09-26-2012: Medicare Compliance Review of Maine Medical Center for Calendar Years 2009 and 2010 (A-01-11-00535)
09-25-2012: Risk Adjustment Data Validation of Payments Made to Paramount Care, Inc., for Calendar Year 2007 (Contract Number H3653) (A-05-09-00044)
09-24-2012: New Jersey Generally Reported Medicaid Overpayments in Accordance With Federal Regulations (A-02-10-01009); New Jersey Did Not Always Claim Federal Medicaid Reimbursement for Personal Care Services Made by Bayada Nurses, Inc., in Accordance With Federal and State Requirements (A-02-10-01001); Blue Cross Blue Shield of Tennessee Overclaimed Supplemental Executive Retirement Plan Costs for Fiscal Years 2005 Through 2009 (A-07-12-00391); Missouri Claimed Federal Reimbursement for Unallowable Personal Care Services Claims (A-07-11-03171)
09-21-2012: Medicare Compliance Review of Centro Cardiovascular de Puerto Rico y del Caribe for the Period January 1, 2008, through June 30, 2010 (A-02-11-01023)
09-12-2012: Alabama Improperly Claimed Federal Funds for Children's Health Insurance Program Enrollees Who Had Medicaid or Other Health Insurance Coverage (A-04-11-08008); South Carolina Claimed Some Unallowable Room-and-Board Costs Under the Intellectual and Related Disabilities Waiver (A-04-11-04012)
09-11-2012: Review of New Mexico Medicaid Personal Care Services Provided by Coordinated Home Health (A-06-09-00064)
09-04-2012: Medicare Overpaid Inpatient Rehabilitation Facilities Millions of Dollars for Claims With Late Patient Assessment Instruments for Calendar Years 2009 and 2010 (A-01-11-00534)
08-28-2012: Review of Medicare Outpatient Billing for Selected Drugs at Essentia Health Duluth (A-09-12-02021)
08-20-2012: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Wisconsin Physicians Service Insurance Corporation But Transitioned to Palmetto Government Benefits Administrator in Jurisdiction 1 for the Period January 1, 2006, Through June 30, 2009 (A-07-11-04182); Blue Cross Blue Shield of Tennessee Overstated the Medicare Segment Pension Assets and Medicare's Share of the Excess Pension Liabilities Due to the Segment Closing (A-07-12-00389); Blue Cross Blue Shield of Tennessee Did Not Claim Some Allowable Pension Costs for Fiscal Years 2003 Through 2009 (A-07-12-00390)
08-17-2012: Medicare Contractors' Payments in Jurisdiction 14 for Full Vials of Herceptin Were Often Incorrect (A-01-11-00539); Wyoming Incorrectly Claimed Enhanced Reimbursement for Medicaid Family Planning Sterilization Costs (A-07-11-01100)
08-16-2012: Massachusetts Medicaid Payments to Newton Health Care Center Did Not Always Comply With Federal and State Requirements (A-01-12-00013); The Medicare Contractor's Payments to Maryland Providers in Jurisdiction 12 for Full Vials of Herceptin Were Sometimes Incorrect (A-03-12-00014)
08-15-2012: Massachusetts Medicaid Payments to Calvin Coolidge Nursing and Rehabilitation Center for Northampton Did Not Always Comply With Federal and State Requirements (A-01-12-00012)
08-14-2012: New York Claimed Some Unallowable Costs for Services by New York City Providers Under the State's Developmental Disabilities Waiver Program (A-02-10-01027)
08-13-2012: Rhode Island Hospice General Inpatient Claims and Payments Did Not Always Meet Federal and State Requirements (A-01-12-00002)
08-10-2012: Medicare Contractors' Payments to Providers in Jurisdiction 11 for Full Vials of Herceptin Were Often Incorrect (A-03-11-00013); Texas Did Not Report Excess Contractor Profits in Accordance With Federal Regulations (A-06-10-00062)
08-07-2012: Review of Medicare Outpatient Billing for Selected Drugs at Methodist Healthcare - Memphis Hospitals (A-09-12-02022); Review of Medicare Outpatient Billing for Selected Drugs at Self Regional Healthcare (A-09-12-02032)
08-06-2012: Medicare Part D Made Some Incorrect Payments to Community Insurance Inc. for Institutional Beneficiaries in 2008 (A-05-11-00042)
08-03-2102: Ashtabula County Medical Center Incorrectly Billed Medicare for Leuprolide Acetate Implants (A-03-12-00010)
07-31-2012: Medicare Contractors' Payments to Providers in Four States in Jurisdiction 12 for Full Vials of Herceptin Were Often Incorrect (A-03-11-00014)
07-27-2012: The Medicare Contractor's Payments in Jurisdictions 6 for Full Vials of Herceptin Were Often Incorrect (A-05-12-00010)
07-25-2012: Nevada Improperly Claimed Federal Reimbursement for Medicare Part B Premiums Paid on Behalf of Medicaid Beneficiaries (A-09-11-02024); Not All of Colorado's Claimed State Children's Health Insurance Program Expenditures Were Allowable (A-07-12-02780)
07-24-2012: Pennsylvania Claimed Medicaid Administrative Costs for Provider Training Under Its Restraint Reduction Initiative. (A-03-11-00209); Medicare Compliance Review of Boston Medical Center for Calendar Years 2009 and 2010 (A-01-11-00530)
07-20-2012: Maine Did Not Always Make Correct Medicaid Claim Adjustments (A-01-12-00001)
07-18-2012: Colorado Did Not Always Identify or Prevent Excluded Providers From Participating in the Medicaid Program (A-07-11-06026); Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Wisconsin Physicians Service Insurance Corporation in Jurisdiction 5 for the Period January 1, 2006, Through June 30, 2009 (A-07-11-04174); Medicare Compliance Review of the Singing River Hospital for Calendar Years 2008 Through 2010 (A-04-11-03069)
07-17-2012: Review of Medicare Outpatient Billing for Selected Drugs at Touchette Regional Hospital (A-09-12-02033); Review of Medicare Outpatient Billing for Selected Drugs at Memorial Health System (A-09-12-02023)
07-12-2012: Review of Medicare Part D Prescription Drug Event Data for Schedule II Drugs at United HealthCare Medicare & Retirement (A-09-11-02023)
07-10-2012: Review of Medicare Outpatient Billing for Selected Drugs at Augusta Health Care, Inc. (A-09-12-02034); Review of Medicare Outpatient Billing for Selected Drugs at Johnston Memorial Hospital (A-09-12-02024); The Medicare Contractor's Payments in Jurisdictions 6, 8, and 15 to Providers for Full Vials of Herceptin Were Often Incorrect (A-05-10-00091)
07-06-2012: Retirement Accumulation Program Costs Claimed by Blue Cross Blue Shield of Tennessee for Fiscal Years 2008 and 2009 Were Reasonable and Allowable (A-07-12-00393); 401(k) Costs Claimed by Blue Cross Blue Shield of Tennessee for Fiscal Years 2005 Through 2009 Were Reasonable and Allowable (A-07-12-00392)
07-02-2012: Medicare Compliance Review of Christiana Care Health System for Calendar Years 2008 Through 2010 (A-03-11-06101); Medicare Compliance Review of West Florida Hospital for Calendar Years 2009 and 2010 (A-04-11-08010); Medicare Compliance Review of Palmetto General Hospital for Calendar Years 2009 and 2010 (A-04-11-07025)
06-29-2012: Audit of Palmetto GBA's Railroad Retirement Board Final Administrative Cost Proposals for Fiscal Years 2007 and 2008 (A-04-11-04018)
06-28-2012: The Centers for Medicare & Medicaid Services Did Not Reconcile Medicare Outlier Payments in Accordance With Federal Regulations and Guidance (A-07-10-02764); Delaware Did Not Comply With Federal Requirements To Report All Medicaid Overpayment Collections (A-03-11-00203); Medicare Could Be Paying Twice for Prescription Drugs for Beneficiaries in Hospice (A-06-10-00059)
06-26-2012: Massachusetts Medicaid Payments to Redstone Rehabilitation and Nursing Center Did Not Always Comply With Federal and State Requirements (A-01-12-00007); Massachusetts Medicaid Payments to Cedar Hill Health Care Center Did Not Always Comply With Federal and State Requirements (A-01-12-00008); Medicare Compliance Review of Tampa General Hospital for Calendar Years 2008 Through 2010 (A-04-11-06138)
06-25-2012: Massachusetts Medicaid Payments to Alliance Health of Massachusetts, Inc., Did Not Always Comply With Federal and State Requirements (A-01-12-00003); Massachusetts Medicaid Payments to Diocesan Health Facilities Did Not Always Comply With Federal and State Requirements (A-01-12-00004)
06-22-2012: States Inappropriately Retained Federal Funds for Medicaid Collections for the First Recovery Act Quarter (A-06-11-00064); AdminaStar Federal, Inc., Claimed Some Unallowable Supplemental Executive Retirement Plan Costs for Medicare Reimbursement for Fiscal Years 2004 Through 2006 (A-07-12-00387)
06-21-2012: Indiana Reduced Medicaid Costs for Home Blood-Glucose Test Strips by Approximately 50 Percent Using Manufacturer Rebates (A-05-12-00011)
06-19-2012: Virginia Commonwealth University Medical Center Incorrectly Billed Medicare for the Biological Drug Myozyme (A-03-12-00009)
06-18-2012: Pennsylvania Did Not Refund the Full Federal Share of Recouped Excess Capitation Payments From the Medicaid Behavioral HealthChoices Program (A-03-10-00204); Montana Did Not Properly Pay Medicare Part B Deductibles and Coinsurance for Outpatient Services (A-07-11-03172)
06-15-2012: North Carolina Incorrectly Claimed Enhanced Federal Reimbursement for Some Medicaid Waiver Services That Were Not Family Planning (A-04-10-01091); North Carolina Incorrectly Claimed Enhanced Federal Reimbursement for Some Medicaid Services That Were Not Family Planning (A-04-10-01089); Review of New Mexico Medicaid Personal Care Services Provided by Clovis Homecare, Inc. (A-06-09-00117)
06-14-2012: Pos-T-Vac Medical Did Not Meet Medicare Documentation Requirements for Over Half of Sampled Claims for Male Vacuum Erection Systems (A-07-11-05016)
06-13-2012: Review of Louisiana Medicaid Personal Care Services Provided by American Pride Caregivers, LLC (A-06-09-00107); Medicare Contractors Lacked Controls To Prevent Millions in Improper Payments for High Utilization Claims for Home Blood-Glucose Test Strips and Lancets (A-09-11-02027)
06-08-2012: West Virginia Complied With Certain Federal Requirements for Most of the Personal Care Services Claimed for Its Aged and Disabled Waiver Program (A-03-11-00205)
06-04-2012: Medicare Continues To Pay Twice for Nonphysician Outpatient Services Provided Shortly Before or During and Inpatient Stay (A-01-10-00508)
05-31-2012: Review of Medicaid Claims for Adult Mental Health Rehabilitation Services Made by Community Residence Providers in New Jersey (A-02-09-01028); WellPoint, Inc. Did Not Always Calculate Enrollees' True-Out-Of-Pocket Costs in Accordance With Federal Requirements (A-05-11-00018)
05-30-2012: Risk Adjustment Data Validation of Payments Made to PacifiCare of Texas for Calendar Year 2007 (Contract Number H4590) (A-06-09-00012)
05-24-2012: Review of Virginia's Buy-In of Medicare Part B Premiums for Medicaid Beneficiaries from January 2008 Through December 2009 (A-03-10-00201); Medicare Overpaid Some Fiscal Year 2008 and 2009 Jurisdiction 13 Inpatient Rehabilitation Facility Claims That Did Not Comply With Transfer Regulations (A-04-11-00079)
05-22-2012: Medicare Compliance Review of New York Downtown Hospital for the Period July 1, 2008, Through December 31, 2010 (A-02-11-01022); Medicare Compliance Review of the University of Colorado Hospital for Calendar Years 2008 and 2009 (A-07-11-05009); Hawaii Claimed Unallowable Medicaid Reimbursement for Nonemergency Medical Transportation Services Furnished by Taxi Providers (A-09-11-02047)
05-21-2012: Fletcher Allen Health Care Did Not Always Bill Correctly for Evaluation and Management Services Related to Eye Injection Procedures (A-01-11-00515)
05-18-2012: Obstacles to Collection of Millions in Medicare Overpayments (A-04-10-03059)
05-17-2012: Most of Missouri's Medicaid Expenditures for the Quarter Ended March 31, 2009, Were Adequately Supported and Allowable (A-07-12-03174); Medicare Compliance Review of South Miami Hospital for Calendar Years 2009 and 2010 (A-04-11-07023); Medicare Compliance Review of Regional Medical Center at Memphis for Calendar Years 2009 and 2010 (A-04-11-00082); Medicare Compliance Review of Piedmont Hospital for Calendar Years 2009 and 2010 (A-04-11-00081); Medicaid Rates for New York State-Operated Developmental Centers May Be Excessive (A-02-11-01029)
05-15-2012: Review of New Mexico Medicaid Personal Care Services Provided by Heritage Home Healthcare (A-06-09-00063)
05-07-2012: Southern California Renal Disease Council, Inc., Claimed Unallowable and Unsupported Costs Under Medicare Contract Number HHSM-500-2006-018C (A-09-11-02044)
05-03-2012: Review of Power Mobility Devices Supplied by Marquis Mobility, Inc. (A-05-10-00042)
05-02-2012: The New York Hotel Trades Council and Hotel Association of New York City, Inc., Health Benefits Fund Reported Unallowable Costs on its Final 2009 Medicare Cost Report (A-02-11-01018)
05-01-2012: Medicare Compliance Review of Barnes Jewish Hospital for Calendar Years 2009 and 2010 (A-07-11-05014); Medicare Compliance Review of Indiana University Health for the Period October 2008 Through September 2010 (A-05-11-00069); Musculoskeletal Global Surgery Fees Often Did Not Reflect the Number of Evaluation and Management Services Provided (A-05-09-00053); Cardiovascular Global Surgery Fees Often Did Not Reflect the Number of Evaluation and Management Services Provided (A-05-09-00054)
04-30-2012: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Wisconsin Physicians Service Insurance Corporation but Transitioned to Highmark Medicare Services in Jurisdiction 12 for the Period January 1, 2006, Through June 30, 2009 (A-07-11-04184); Review of Outpatient Brachytherapy Medicare Payments to Lakewood Ranch Medical Center (A-04-10-06131)
04-27-2012: Michigan Did Not Perform Eligibility Redeterminations at Least Every 12 Months for Wayne County Medicaid Beneficiaries (A-05-11-00045)
04-24-2012: Review of Medicare Outpatient Billing for Selected Drugs at Community Hospital of San Bernardino (A-09-11-02069); Medicare Overpaid Some Fiscal Year 2008 and 2009 Jurisdiction 4 Inpatient Rehabilitation Facility Claims That Did Not Comply With Transfer Regulations Audit (A-04-11-00078); Utah Did Not Always Correctly Claim Medicaid Costs for Selected High-Dollar Outpatient Claims Audit (A-07-11-04177)
04-23-2012: Missouri Did Not Always Correctly Claim Medicaid Costs for Selected High-Dollar Outpatient Claims Audit (A-07-11-04180); Review of Medicaid Payments for Services Under New Jersey's Section 1915(c) Community Care Waiver Program From January 1, 2005, Through December 31, 2007 Audit (A-02-10-01029); Southern California Renal Disease Council, Inc., Claimed Unallowable and Unsupported Costs Under Medicare Contract Number 500-02-NW18CH Audit (A-09-11-02005)
04-20-2012: Review of Selected Medicaid Home Health Services Claims Made by Jewish Home and Hospital Lifecare Community Services - Manhattan LTHHCP Audit (A-02-10-01002)
04-17-2012: Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in the U.S. Virgin Islands for the Quarter Ended September 30, 2009 (A-02-11-01004)
04-16-2012: St. Luke's Episcopal Church Home Care Program-Juana Diaz Properly Claimed Medicare Reimbursement for Home Health Services (A-02-11-01009)
04-13-2012: Illinois Did Not Report All Medicaid Overpayments In Accordance With Federal Requirements Audit (A-05-11-00044); Review of Medicare Outpatient Billing for Selected Drugs at O'Connor Hospital (A-09-12-02010); Review of Medicare Outpatient Billing for Selected Drugs at University of Utah Hospitals and Clinics (A-09-12-02008); Donor Network of Arizona Did Not Fully Comply With Medicare Requirements for Reporting Organ Statistics and Related Costs in Its Fiscal Year 2009 Medicare Cost Report (A-09-11-02035)
04-12-2012: Most of Mutual of Omaha's Medicare Administrative Costs Reported for Fiscal Years 2007 and 2008 Were Allowable (A-07-11-03166); Postretirement Benefit Costs Claimed by Wisconsin Physicians Service Insurance Corporation for Fiscal Years 1999 Through 2001 Were Reasonable and Allowable (A-07-12-00388); Medicare Compliance Review of Bay Medical Center for Calendar Years 2009 and 2010 (A-04-11-08006); Medicare Compliance Review of Kent County Hospital for Calendar Years 2009 and 2010 (A-01-11-00537)
04-09-2012: Medicare Compliance Review of Georgetown University Hospital for Calendar Years 2009 and 2010 (A-03-11-00010)
04-05-2012: Claim Modifier Did Not Prevent Medicare From Paying Millions in Unallowable Claims for Selected Durable Medical Equipment (A-04-10-04004)
04-04-2012: Review of the Pension Costs Claimed by Group Health Incorporated for Plan Years 1999 Through 2006 (A-07-12-00380); Review of Medicare Part B Pension Costs Claimed by Group Health Incorporated for Plan Years 1987 Through 2008 (A-07-12-00379); Audit of Group Health Incorporated's Cash Balance Pension Plan Unfunded Pension Costs for Plan Years 2003 Through 2007 (A-07-12-00376)
04-03-2012: Review of Colorado Direct Medical Service and Specialized Transportation Costs for the Medicaid School Health Services Program for State Fiscal Year 2008 (A-07-11-04185); Review of the Pension Segmentation Requirements for the Cash Balance Pension Plan at Group Health Incorporated for the Period of September 1, 2003, to January 1, 2009 (A-07-12-00374); Review of the Pension Segmentation Requirements for the EmblemHealth Services Company, LLC, Employees' Retirement Plan at Group Health Incorporated for the Period of January 1, 2008, to January 1, 2009 (A-07-12-00378); Audit of Group Health Incorporated's Local 153 Pension Plan Unfunded Pension Costs for Plan Years 1987 Through 2007 (A-07-12-00375)
04-02-2012: Review of Resident Data Reported in the Intern and Resident Information System for Medicare Cost Reports Submitted to National Government Services, Inc., and Highmark Medicare Services, Inc. (A-02-10-01007); Review of Resident Data Reported in the Intern and Resident Information System for Medicare Cost Reports Submitted to Highmark Medicare Services, Inc., and National Government Services, Inc. (A-02-10-01006)
03-29-2012: Arizona Improperly Claimed Federal Reimbursement for Medicare Part B Premiums Paid on Behalf of Medicaid Beneficiaries (A-09-11-02009)
03-26-2012: Massachusetts Generally Complied With Federal and State Requirements for Medicaid Payments to Wingate Healthcare (A-01-11-00010); Rhode Island Did Not Always Comply With State Requirements on Medicaid Payments for Hospice Services (A-01-11-00005); Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in Washington State (A-09-10-02013)
03-22-2012: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Wisconsin Physicians Service Insurance Corporation but Transitioned to TrailBlazer Health Enterprises, LLC, in Jurisdiction 4 for the Period January 1, 2006, Through June 30, 2009 (A-07-11-04183); Review of Medicaid Payments for Services Provided Under New Jersey's Section 1915(c) Community Care Waiver by Bancroft NeuroHealth From January 1, 2005, Through December 31, 2007 (A-02-09-01034)
03-21-2012: A Medicare Contractor's Claimed Administrative Costs Were Generally Allowable (A-04-10-00067)
03-16-2012: Review of Medicare Outpatient Billing for Selected Drugs at Oregon Health & Science University (A-09-12-02011); Review of Medicare Outpatient Billing for Selected Drugs at Catskill Regional Medical Center (A-09-12-02007); Medicare Compliance Review of Brigham and Women's Hospital for Calendar Years 2009 and 2010 (A-01-11-00521)
03-13-2012: Ohio Medicaid Costs for Home Blood-Glucose Test Strips Could Be Reduced by Approximately 50 Percent (A-05-11-00098)
03-12-2012: Review of Pension Costs Claimed for Medicare Durable Medical Equipment Regional Carrier Reimbursement by HealthNow New York, Inc., for Fiscal Years 2000 Through 2007 (A-07-11-00367); Review of Medicare Contractor's Pension Segmentation Requirements for the Durable Medical Equipment Regional Carrier Segment at HealthNow New York, Inc., a Terminated Medicare Contractor, for the Period January 1, 2002, to January 1, 2007 (A-07-11-00366); Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in Colorado (A-07-11-02758); St. John's Hospital Reported Costs for Outpatient Services on its 2010 Medicare Cost Report that Complied with Federal Requirements (A-05-11-00107); Review of New Mexico Medicaid Personal Care Services Provided by Ambercare Home Health (A-06-09-00062)
03-09-2012: Review of CERT Errors Overturned Through the Appeals Process for Fiscal Years 2009 and 2010 (A-01-11-00504)
03-08-2012: Review of Medicaid Administrative Costs Claimed by New Jersey for State Fiscal Years 2005 and 2006 (A-02-08-01009); Review of Medicare Outpatient Billing for Selected Drugs at Bates County Memorial Hospital (A-09-12-02009)
03-07-2012: Review of Medicare Contractor's Pension Segmentation Requirements for the Medicare Part B Segment at HealthNow New York, Inc., for the Period April 1, 1995, to January 1, 2007 (A-07-11-00363); Audit of HealthNow New York, Inc.'s Unfunded Pension Costs for 1995 Through 2006 (A-07-11-00365); Review of Pension Costs Claimed for the Medicare Part B Segment by HealthNow New York Inc. for Fiscal Years 1995 Through 2006 (A-07-11-00364); Southern California Renal Disease Council, Inc., Claimed Unallowable and Unsupported Costs Under Medicare Contract Number 500-03-NW18 (A-09-10-02045)
02-29-2012: Piedmont Hospital Did Not Fully Comply With Medicare Requirements for Obtaining and Reporting Credits for Replacement Cardiac Medical Devices (A-04-11-03065); Nebraska Did Not Properly Pay Some Medicare Part B Deductibles and Coinsurance (A-07-11-03168)
02-28-2012: Medicare Compliance Review of University of California, San Diego, Medical Center for Calendar Years 2008 and 2009 (A-09-11-02055); Medicare Compliance Review of John Muir Medical Center, Walnut Creek, for Calendar Years 2008 Through 2010 (A-09-11-02060)
02-27-2012: Contract Provisions for the Hawaii QUEST Expanded Access Risk Share Program Not Implemented (A-09-12-02006); Federal Survey Requirements Not Always Met for Three California Nursing Homes Participating in the Medicare and Medicaid Programs (A-09-11-02019); Review of Medicare Outpatient Billing for Selected Drugs at NorthBay Medical Center (A-09-11-02071); Review of Medicare Part D Prescription Drug Event Data for Schedule II Drugs at CVS Caremark Corporation (A-09-11-02074)
02-23-2012: Audit of Palmetto GBA's Medicare Part B Final Administrative Cost Proposals for Fiscal Years 2007 Through 2009 (A-04-11-04013); Review of Michigan Medicaid Payments to Terminated Providers for Posttermination Services (A-05-10-00082)
02-14-2012: Review of Medicare Acute Care Inpatient Same-Day Readmissions at Thomas Jefferson University Hospitals, Inc. (A-03-11-00008)
02-13-2012: Review of Medicaid Payments for Nonemergency Medical Transportation Services Claims Submitted by Providers in New York State (A-02-09-01024); Pilot Project to Obtain Missing Documentation Identified in the Fiscal Year 2010 CERT Program (A-01-11-00502)
02-10-2012: Review of Outpatient Claims Processed by Wisconsin Physicians Service That Included Procedures for the Insertion of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009 (A-01-11-00532)
02-09-2012: Medicare Compliance Review of Riverside Methodist Hospital for Calendar Years 2008 Through 2010 (A-05-11-00058); Medicare Compliance Review of St. Vincent's Medical Center for Calendar Years 2009 and 2010 (A-01-11-00517)
02-06-2012: Review of Outpatient Brachytherapy Medicare Payments to Carolinas Medical Center (A-04-11-06135); Review of Nebraska's Medicaid Payments for Dual Eligible Individuals' Medicare Part A Deductibles and Coinsurance (A-07-11-03161)
02-01-2012: Review of Pension Costs Claimed for Wisconsin Physicians Service Insurance Corporation for Fiscal Years 1990 to 2007 (A-07-11-00369); Review of the Pension Segmentation Requirements for the Represented Employees' Retirement Income Plan at Wisconsin Physicians Service Insurance Corporation for the Period of August 1, 1998, to December 31, 2007 (A-07-11-00356); Medicare Compliance Review of Kendall Regional Medical Center for Calendar Years 2009 and 2010 (A-04-11-07022); Medicare Compliance Review of Springhill Medical Center for Calendar Years 2008 and 2009 (A-04-11-03067)
01-27-2012: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by TrailBlazer Health Enterprises, LLC, in Jurisdiction 4 for the Period January 1, 2006, Through June 30, 2009 (A-06-10-00045)
01-26-2012: Oregon Improperly Claimed Federal Reimbursement for Medicaid Family Planning Services Provided Under the Family Planning Expansion Project (A-09-11-02010)
01-23-2012: Review of Acute Care Inpatient Same-Day Readmissions at St. Mary's Hospital (A-03-11-00009)
01-19-2012: Review of Medicaid Payments for School-Based Health Services Made to Manchester, New Hampshire (A-01-10-00014)
01-18-2012: Review of Illinois' Reporting of Fund Recoveries in the Appeals Process on the Form CMS-64 (A-05-11-00052); Review of Controls at SilverScript Insurance Company to Ensure Adherence to Formularies (A-07-11-06029)
01-12-2012: Review of Medicaid Personal Care Claims Submitted by Providers in New Jersey (A-02-09-01002)
01-05-2012: Review of Oklahoma Collections for the Medical Assistance Program for Calendar Years 2004 Through 2009 (A-06-10-00057); Review of Resident Data Reported in the Intern and Resident Information System for Medicare Cost Reports Submitted to Highmark Medicare Services, Inc. (A-02-09-01019); Review of Medicare Acute Care Inpatient Same-Day Readmissions at University of Pittsburgh Medical Center Presbyterian Shadyside Hospital (A-03-10-00013)
01-04-2012: Medicare Compliance Review of Broward General Medical Center for Calendar Years 2008 and 2009 (A-04-11-07021); Medicare Compliance Review of MetroWest Medical Center for Calendar Years 2009 and 2010 (A-01-11-00513)

2011

12-29-2011: Review of Medicaid Personal Care Claims Submitted by Providers in New Jersey (A-02-09-01002)
12-23-2011: Review of Excluded Providers in the Medicare Part D Program (A-07-10-06004)
12-21-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by NHIC, Corp., in Jurisdiction 14 for the Period January 1, 2006, Through June 30, 2009 (A-01-10-00502)
12-20-2011: Review of Arkansas' Reporting Fund Recoveries for Federal and State Medicaid Programs on the CMS-64 Report for State Fiscal Year 2009 (A-06-10-00051)
12-19-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Pinnacle in Jurisdiction 7 for the Period January 1, 2006, Through June 30, 2009 (A-06-10-00046)
12-16-2011: Review of Medicare Outpatient Billing for Selected Drugs at Marian Medical Center (A-09-11-02056); Review of Medicare Outpatient Billing for Selected Drugs at Eisenhower Medical Center (A-09-11-02066)
12-15-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by National Government Services, Inc., in Jurisdiction 6 - Illinois and Wisconsin for the Period January 1, 2006, Through June 30, 2009 (A-05-10-00025)
12-14-2011: Review of Medicare Part D Prescription Drug Event Data for Schedule II Drugs at Hawaii Medical Service Association (A-09-11-02028)
12-13-2011: Review of Medicaid Payments to Excluded or Terminated Durable Medical Equipment Suppliers in Florida During Calendar Year 2009 (A-04-11-07020)
12-12-2011: Northwestern Memorial Hospital in Chicago, Illinois, Met Applicable Medicare Payment Requirements for Yttrium-90 Brachytherapy Claims (A-04-11-06139)
12-05-2011: Review of Medicare Outpatient Billing for Selected Drugs at Dominican Hospital (A-09-11-02046)
11-30-2011: Medicare Compliance Review of Tallahassee Memorial HealthCare, Inc. for Calendar Years 2009 and 2010 (A-04-11-08003); Medicare Compliance Review of Norwood Hospital for the Period July 2008 Through June 2010 (A-01-11-00510); Review of Medicare Payments Exceeding Charges by $500 to $1,000 for Outpatient Services Processed by National Government Services but Transitioned to Palmetto GBA, LLC, in Jurisdiction 11 for the Period January 1, 2006, Through June 30, 2009 (A-03-11-00005); Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by National Government Services but Transitioned to Palmetto GBA, LLC, in Jurisdiction 11 for the Period January 1, 2006, Through June 30, 2009 (A-03-10-00005); Review of Medicaid Payments for Nonemergency Medical Transportation Services Claims Submitted by Providers in New York City (A-02-08-01017)
11-29-2011: Review of Medicare Outpatient Billing for Selected Drugs at Sierra Nevada Memorial Hospital (A-09-11-02061)
11-28-2011: Audit of Medicare Part B Administrative Costs for the Period October 1, 2006, Through September 30, 2008, at Wisconsin Physicians Service Insurance Corporation (A-05-09-00096); Review of Medicare Outpatient Billing for Selected Drugs at Enloe Medical Center (A-09-11-02062); Review of Medicare Outpatient Billing for Selected Drugs at Providence Centralia Hospital (A-09-11-02059); Review of Medicare Outpatient Billing for Selected Drugs at Yakima Valley Memorial Hospital (A-09-11-02058); Place-of-Service Overpayments Refund Verification for Boston Medical Center for Calendar Years 2006 Through 2010 (A-01-11-00508); Review of the Centers for Medicare & Medicaid Services' Audits of Part D Sponsors' Financial Records (A-03-10-00007)
11-22-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by First Coast Service Options, Inc., in Jurisdiction 9 for the Period January 1, 2008, Through June 30, 2009 (A-04-10-06128); Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Cahaba Government Benefit Administrators, LLC, in Jurisdiction 10 for the Period January 1, 2008, Through June 30, 2009 (A-04-10-06127); Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Cahaba Government Benefit Administrators, LLC, in Jurisdiction 10 for the Period January 1, 2006, Through December 31, 2007 (A-04-10-06121); Review of Blue Cross and Blue Shield of Georgia, Inc.'s Medicare Part A Termination Costs for the Period May 5, 2009, Through June 30, 2010 (A-04-10-00075)
11-17-2011: Review of Medicare Outpatient Billing for Selected Drugs at Los Robles Hospital & Medical Center (A-09-11-02065); Oregon's Internal Controls Were Substantially Adequate To Prevent Medicaid Payments to Excluded Providers (A-09-11-02042)
11-15-2011: Review of the Qualified Pension Plan at Blue Cross Blue Shield of Nebraska, A Terminated Medicare Contractor, for the Period January 1, 1994, to November 30, 2007 (A-07-11-00370); Review of Pension Costs Claimed for Medicare Reimbursement by Blue Cross Blue Shield of Nebraska for Fiscal Years 1995 Through 2008 (A-07-11-00371)
11-10-2011: Review of Personal Care Services Claimed Under Maryland's Medicaid State Plan (A-03-11-00200)
11-04-2011: Review of Medicaid Administrative Costs Claimed by New Jersey for State Fiscal Year 2007 (A-02-07-01050)
11-02-2011: Review of Outpatient Claims Processed by National Government Services, Inc., That Included Procedures for the Insertion of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009 (A-01-11-00524)
11-01-2011: Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in Nebraska (A-07-11-02759)
10-27-2011: Review of National Government Services' Final Administrative Cost Proposal for Fiscal Year 2007 (A-05-10-00074)
10-25-2011: Medicare Compliance Review of St. John's Hospital for Calendar Years 2008 and 2009 (A-07-11-01098)
10-24-2011: Review of Cleveland Clinic's Claims for Procedures That Included the Replacement of Medical Devices During 2008 and 2009 (05-11-00012); Review of Outpatient Claims Processed by Noridian Administrative Services That Included Procedures for the Insertion of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009 (A-01-11-00528)
10-20-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by National Government Services in Jurisdiction 15 for the Period January 1, 2006, Through June 30, 2009 (A-05-10-00016)
10-19-2011: Review of Riverbend Government Benefits Administrator's Medicare Part A Termination Costs for the Period August 4, 2009, Through March 3, 2010 (A-04-10-00071)
10-18-2011: Review of Drug Costs to Medicaid Pharmacies and Their Relation to Benchmark Prices (A-06-11-00002)
10-17-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by TriSpan but Transitioned to Pinnacle in Jurisdiction 7 for the Period January 1, 2006, Through June 30, 2009 (A-06-10-00048); Audit of Medicare Part A and Part B Administrative Costs for the Period October 1, 2006, Through September 30, 2007 at National Government Services-Medicare Contractor Numbers 00130 and 00630 (A-05-10-00075); Review of Prescribed Drug Costs in the Colorado Medicaid Family Planning Program (A-07-11-01095)
10-14-2011: Review of Institutional Medicare Beneficiaries' Minimum Data Set Classification for Harmony Health Plan of Illinois, Inc. (H1416) for Calendar Year 2008 (A-05-11-00086)
10-13-2011: Multi-State Review of Centers for Medicare & Medicaid Services Medicaid Drug Expenditure Controls (A-07-10-06003)
10-12-2011: Review of Medicaid Claims Submitted by Continuing Day Treatment Providers in New York State Audit (A-02-09-01023)
10-07-2011: Review of Medicare Payments for NovoSeven Coagulation Factor VIIA to Indiana Hemophilia and Thrombosis Center, Inc. From January 1, 2008, Through December 31, 2009 (A-05-11-00027)
10-06-2011: Review of Medicare Outpatient Billing for a Selected Drug at Madison Memorial Hospital (A-09-11-02051); Review of Medicare Outpatient Billing for Selected Drugs at Central Peninsula General Hospital (A-09-11-02033)
10-05-2011: Review of Medicare Payments Exceeding Charges By $500 to $1,000 for Outpatient Services Processed by Palmetto GBA, LLC, in Jurisdiction 11 for the Period January 1, 2006, Through June 30, 2009 (A-03-11-00006); Review of Costs for Inpatient Services in the Colorado Medicaid Family Planning Program Audit (A-07-11-01097); Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Palmetto GBA, LLC, in Jurisdiction 11 for the Period January 1, 2006, Through June 30, 2009 Audit (A-03-10-00006); Review of Select Medicare Payments Exceeding Charges for Outpatient Services Processed by National Government Services in Jurisdiction 13 for the Period January 1, 2006, Through June 30, 2009 Audit (A-02-10-01008)
10-04-2011: Review of American Recovery and Reinvestment Act of 2009 Medicaid Prompt Pay Requirements in Nebraska (A-07-11-06019); Review of Costs Claimed for Selected High-Dollar Outpatient Services in the Colorado Medicaid Program During the Period January 1, 2007, Through December 31, 2009 (07-11-04178)
10-03-2011: Review of Pension Costs Claimed for Medicare Reimbursement by Blue Cross Blue Shield of Mississippi for Fiscal Years 1997 Through 2009 (A-07-11-00350); Review of the Qualified Pension Plan at Blue Cross Blue Shield of Mississippi, A Terminated Medicare Contractor, for the Period January 1, 1996, to September 30, 2009 (A-07-11-00349)
09-29-2011: Verification of Saint Francis Medical Center's Refund of Place-of-Service Overpayments for Calendar Years 2009 Through 2010 (A-01-11-00512)
09-26-2011: Medicare Compliance Review of Baystate Medical Center for Calendar Years 2008 and 2009 (A-01-11-00500)
09-23-2011: Review of Medicaid Hospice Payments at Evercare Hospice & Palliative Care for State Fiscal Years 2007 Through 2009 (A-01-10-00012)
09-22-2011: Review of Outpatient Claims Processed by First Coast Service Options, Inc., That Included Procedures for the Insertion of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009 (A-01-11-00523); Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2009 (A-18-10-30300)
09-21-2011: Unidentified and Unreported Federal Deficiencies in California's Complaint Surveys of Nursing Homes (A-09-09-00114); Medicare Compliance Review of University of California, San Francisco, Medical Center for Calendar Years 2008 and 2009 (A-09-11-02034)
09-20-2011: Review of Medicare Part D Prescription Drug Event Data for Schedule II Drugs at Health Net, Inc. (A-09-10-02046)
09-15-2011: Review of Louisiana Medicaid Physician Family Planning Services (A-06-10-00075)
09-14-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Noridian Administrative Services, LLC, in Jurisdiction 6 - Minnesota for the Period January 1, 2006, Through June 30, 2009 (A-05-10-00020); Review of Outpatient Claims Processed by Palmetto GBA That Included Procedures for the Insertion Of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009 (A-01-11-00520)
09-13-2011: Review of Medicaid Credit Balances at Private Diagnostic Clinic, PLLC, at Duke University Medical Center as of March 31, 2010 (A-04-10-04007)
09-12-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by National Government Services in Jurisdiction 8 for the Period January 1, 2006, Through June 30, 2009 (A-05-10-00017)
09-07-2011: Review of Place-of-Service Coding for Physician Services Processed by Medicare Part B Contractors During Calendar Year 2009 (A-01-10-00516); Review of Place-of-Service Coding for Physician Services Processed by Medicare Part B Contractors During Calendar Year 2008 (A-01-10-00513)
09-06-2011: Review of Medicare Part B Avastin and Lucentis Treatments for Age-Related Macular Degeneration (A-01-10-00514)
08-31-2011: Audit of Oregon's Medicaid Management Information System Expenditures for the Period October 1, 2007, Through September 30, 2009 (A-09-10-02017)
08-31-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by First Coast Service Options, Inc., in Jurisdiction 9 for the Period January 1, 2006, Through December 31, 2007 (A-04-10-06120)
08-29-2011: Review of Medicaid Residential Rehabilitation Services for Children in Maryland (A-03-08-00209); Review of Outpatient Claims Processed by Cahaba Government Benefit Administrators That Included Procedures for the Insertion of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009 (A-01-11-00522)
08-23-2011: Review of Aetna, Inc., Pharmacy Audit Recoveries for Medicare Part D Drugs Dispensed in Calendar Year 2008 (A-03-11-00001)
08-22-2011: Review of Provider Compliance With the District of Columbia's Medicaid Durable Medical Equipment Program Standards for Physical Presence (A-03-11-00202)
08-16-2011: Review of Blue Cross and Blue Shield of Georgia, Inc.'s Medicare Final Administrative Cost Proposals for the Period October 1, 2006, Through May 4, 2009 (A-04-10-00068)
08-12-2011: Review of Medicare Payments Exceeding Charges By $500 to $1,000 for Outpatient Services Processed by Highmark Medicare Services in Jurisdiction 12 for the Period January 1, 2006, Through June 30, 2009 (A-03-11-00004); Nationwide Rollup Report for Medicaid Drug Rebate Collections (A-06-10-00011); Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Highmark Medicare Services in Jurisdiction 12 for the Period January 1, 2006, Through June 30, 2009 (A-03-10-00004)
08-10-2011: Review of Outpatient Claims Processed by Trailblazer Health Enterprises, LLC That Included Procedures for the Insertion of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009 (A-01-10-00515)
08-04-2011: Review of Humana, Inc., Preferred Provider Organization Controls Over Durable Medical Equipment Suppliers in Florida (A-04-10-07017)
08-03-2011: Review of Select Medicaid Inpatient Psychiatric Hospital Service Requirements for One Illinois State-Owned Psychiatric Hospital During the Period January 1, 2000, Through December 31, 2009 (A-05-10-00046)
08-02-2011: Review of Arkansas Medicaid Prescription Drug Claims for the Quarter Ending December 31, 2008 (A-06-09-00093)
07-28-2011: Review of Medicaid Payments for Services Provided Under New Jersey's Section 1915(c) Community Care Waiver by Elwyn New Jersey From January 1, 2005, Through December 31, 2007 (A-02-09-01033)
07-27-2011: Medicaid Hospital Outlier Payment Followup for Fiscal Years 2004 Through 2006 (A-07-10-04160); Review of Medicare Part B Transition and Termination Costs Claimed by Group Health Incorporated (A-02-09-01027); Review of South Dakota's Buy-In of Medicare Part B Premiums for Medicaid Beneficiaries from October 2008 Through September 2009 (A-07-10-02757)
07-22-2011: Review of Costs Claimed by the State of Nebraska for Non-Emergency Medical Transportation Services Provided by Shared Mobility Coach (A-07-10-04172)
07-21-2011: Review of the Massachusetts Executive Office of Health and Human Services Buy-In of Medicare Parts A and B for the Period July 2008 Through December 2009 (A-01-11-00004)
07-20-2011: Review of Medicaid Expenditures for Medicare Part A and Part B Premiums in Missouri (A-07-10-03158)
07-19-2011: Review of Medicaid Administrative Costs Claimed for the Pennsylvania Department of Aging's Direct Care Worker Initiative (A-03-10-00206)
07-18-2011: Review of Medicaid Payments to Senior Solutions Healthcare Management and Consulting, LLC for State Fiscal Years 2007 Through 2010 (A-01-11-00003); Review of Medicare Fee-for-Service Payments Made by TrailBlazer Health Enterprises, LLC, for Medicare Advantage Enrollees During Calendar Years 2007 and 2008 (A-07-11-05013); Review of Medicare Fee-for-Service Payments Made by Palmetto Government Benefit Administrators for Medicare Advantage Enrollees During Calendar Years 2007 and 2008 (A-07-11-05012)
07-15-2011: Review of Medicaid Administrative Costs Claimed for the Pennsylvania Department of Aging's Healthy Steps Program (A-03-10-00205)
07-14-2011: Review of the Pension Segmentation Requirements for the Local 153 Pension Plan at Group Health Incorporated for the Period of April 1, 1987, to January 1, 2009 (A-07-11-00358)
07-11-2011: Medicare Compliance Review of Cape Cod Hospital for Calendar Years 2008 and 2009 (A-01-10-00530)
07-08-2011: Review of Medicare Fee-for-Service Payments Made by National Government Services, Inc., for Medicare Advantage Enrollees During Calendar Years 2007 and 2008 (A-07-11-05010)
07-06-2011: Review of Practitioner Compliance With the Requirements of the Hurricane Katrina Health-Care-Related Professional Workforce Supply Grant for the Greater New Orleans Area (A-06-09-00051); Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in Oklahoma (A-06-09-00097)
07-05-2011: Nebraska Medicaid Payments for Personal Care Services (A-07-10-03152)
06-29-2011: Review of Medicaid Family Planning Services Claimed Under the Oregon Health Plan During the Period October 1, 2006, Through September 30, 2009 (A-09-10-02043)
06-29-2011: Review of Florida's Children's Health Insurance Program Experience Adjustment and Refund Submission Reports (A-04-10-06123)
06-28-2011: Review of Medicaid Credit Balances at Natividad Medical Center as of October 31, 2010 (A-09-11-02000)
06-28-2011: Review of Administrative Costs Claimed by Pennsylvania's Home and Community-Based Waiver for Individuals Aged 60 and Over (A-03-10-00202)
06-24-2011: Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in Iowa (A-07-11-03165)
06-20-2011: Review of the Pension Segmentation Requirements at Blue Cross Blue Shield of Georgia for the Period January 1, 2001, to June 30, 2006 Audit (A-07-10-00344); Review of Pension Costs Claimed for Medicare Reimbursement by Blue Cross Blue Shield of Georgia for Fiscal Years 2001 Through 2005 Audit (A-07-10-00345)
06-15-2011: Review of Medicaid High-Dollar Payments for Inpatient Services in New York State From January 1, 2008, Through November 30, 2009 (A-02-10-01036)
06-14-2011: Review of CIGNA Government Services Durable Medical Equipment Regional Carrier Medicare Termination Cost Vouchers for the Period October 1, 2006, Through October 31, 2007 (A-04-07-00033)
06-03-2011: Review of Medicaid Personal Care Services Claimed by Washington State (A-09-09-00030); Review of Medicaid Personal Care Services Claims Submitted by Providers in North Carolina (A-04-10-04003)
06-02-2011: Medicare Compliance Review of Fletcher Allen Health Care for Calendar Years 2008 and 2009 (A-01-10-00527)
06-01-2011: Review of Medicaid Payments for Services Provided Under New York's Section 1915(c) Traumatic Brain Injury Waiver at Belvedere of Albany, LLC, From January 1, 2005, Through December 31, 2007 (A-02-09-01006)
05-26-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Noridian Administrative Services, LLC, in Jurisdiction 3 for the Period January 1, 2006, Through June 30, 2009 (A-07-10-04163); Audit of HealthNow New York, Inc.'s Medicare Part B Final Administrative Cost Proposal for Fiscal Year 2008 (A-02-09-01039)
05-25-2011: Review of Additional Claims for Sterilization Procedures in the Colorado Medicaid Family Planning Program (A-07-11-01096); Review of State of Minnesota Reporting Medicaid Fraud Control Unit Funds Recoveries on the CMS-64 for the Period October 1, 2005, Through December 31, 2008 (A-05-10-00043); Review of Medicaid Hysterectomy Expenditures Claimed as Family Planning in Oklahoma for Calendar Years 2005 to 2009 (A-06-10-00047); Review of Medicaid Payments for Services Provided Under New York's Section 1915(c) Traumatic Brain Injury Waiver at Venture Forthe, Inc., From January 1, 2005, Through December 31, 2007 (A-02-09-01005)
05-24-2011: Audit of Medicare Part A Administrative Costs for the Period November 5, 2007, Through September 30, 2008 at Wisconsin Physicians Service Insurance Corporation (A-05-09-00101)
05-23-2011: Review of Termination Claim for Postretirement Benefits Made by Blue Cross Blue Shield of Mississippi (A-07-11-00359)
05-20-2011: Review of Louisiana Medicaid Inpatient Hospital Family Planning Services (A-06-10-00076)
05-18-2011: Verification of Hillcrest Baptist Medical Center's Refund of Place-of-Service Overpayments for Calendar Years 2007 Through 2009 (A-01-10-00528); Review of District of Columbia Medicaid Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Provider Enrollment Practices (A-03-10-00203); Review of Medicare Payments to Arimed Orthotics and Prosthetics, Inc., for Lower Limb Prosthetic Services for the Period January 1, 2008, Through December 31, 2009 (A-02-11-01005)
05-17-2011: Review of Medicare Payments to Prescription Drug Plans on Behalf of Deceased Enrollees (A-05-09-00027)
05-16-2011: Review of Select Medicare Conditions of Participation and Costs Claimed at Richards Memorial Hospital from October 1, 2004, Through September 30, 2007 (A-05-08-00083)
05-12-2011: Review of Medicare Contractor's Pension Segmentation Requirements at National Heritage Insurance Company for the Period January 1, 2000, to January 1, 2008 (A-07-11-00362); Review of Child Delivery Claims and Newborn Claims Included in the Kansas Medicaid Family Planning Program (A-07-10-04156); Review of Medicaid Services to Incarcerated Juveniles in the State of South Carolina During Federal Fiscal Years 2004 and 2005 (A-04-07-00034)
05-09-2011: Verification of Central Vermont Medical Center's Refund of Place-of-Service Overpayments for Calendar Years 2007-2010 (A-01-11-00507)
05-06-2011: Review of Physician Therapy Services Provided During Home Health Episodes in Calendar Year 2008 (A-01-09-00530)
05-03-2011: Review of the Hospital of Saint Raphael's Claims for Inpatient & Outpatient Procedures That Included the Replacement of Medical Devices for Calendar Years 2008 and 2009 (A-01-10-00512)
04-28-2011: Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Noridian Administrative Services, LLC, in Jurisdiction 2 for the Period January 1, 2006, Through June 30, 2009 (A-09-10-02019)
04-27-2011: Review of High-Dollar Payments Processed by National Government Services for Long-Term Care Inpatient Services Provided Between October 1, 2006, and December 31, 2007 (A-05-09-00100)
04-11-2011: Review of Pension Costs Claimed for Medicare Reimbursement by Mutual of Omaha Insurance Company for Fiscal Years 1992 Through 2007 (A-07-11-00348); Review of the Qualified Pension Plan at Mutual of Omaha Insurance Company, a Terminated Medicare Contractor, for the Period January 1, 1992, to January 1, 2008 (A-07-11-00347)
04-07-2011: Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in New York State for the Quarter Ended September 30, 2009 (A-02-10-01020); Review of Pension Costs Claimed for Medicare Reimbursement by Cahaba Government Benefit Administrators, LLC, for Fiscal Years 2003 Through 2009 (A-07-11-00361); Review of Medicare Contractor's Pension Segmentation Requirements at Cahaba Government Benefit Administrators, LLC, for the Period January 1, 2002, to January 1, 2009 (A-07-11-00360); Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in Puerto Rico for the Quarter Ended September 30, 2009 (A-02-10-01038); Review of the Maine Department of Health and Human Services Buy-In of Medicare Parts A and B for the Period July 1, 2008, Through December 31, 2009 (A-01-10-00013)
03-31-2011: Review of Medicaid Payments for Deceased Recipients in New Mexico (A-06-10-00093)
03-18-2011: Family Planning Services Claimed by Illinois From October 1, 2007, Through September 30, 2009 (A-05-10-00053)
03-17-2011: Review of CIGNA Government Services Durable Medical Equipment Regional Carrier Final Administrative Cost Proposals for Fiscal Years 2004 Through 2006 (A-04-07-00032)
03-16-2011: Review of CIGNA Government Services Part B Final Administrative Cost Proposals for Fiscal Years 2004 Through 2006 (A-04-07-00031)
03-11-2011: Family Planning Services Claimed by Ohio from October 1, 2007, through September 30, 2009 (A-05-10-00035)
03-02-2011: Review of Erectile Dysfunction Drugs in the Medicare Part D Program (A-07-10-03143); Medicare Compliance Review of South Shore Hospital for Calendar Years 2008 and 2009 (A-01-10-00521); Review of Colorado's Monitoring of Community Services Block Grants (A-07-10-02761)
02-28-2011: Review of Family Planning Services Claimed by Washington State During the Period October 1, 2005, Through September 30, 2008 (A-09-09-00049); Review of the Pension Segmentation Requirements for the Managerial Pension Plan at Wisconsin Physicians Service Insurance Corporation for the Period of January 1, 1989, to January 1, 2008 (A-07-10-00336)
02-24-2011: Review of Jurisdiction 5 Payments for Inpatient Rehabilitation Facility Claims Billed with Patient Status Code 05 for Calendar Year 2007 (A-01-10-00518)
02-17-2011: Review of Medicaid Hospice Payments Made by Massachusetts for State Fiscal Years 2007 and 2008 (A-01-10-00004); Review of Medicare Contractor Information Security Program Evaluations for Fiscal Year 2008 (A-18-09-30200); Review of Medicare Claims for Home Blood-Glucose Test Strips and Lancets-Durable Medical Equipment Medicare Administrative Contractor for Jurisdiction B (A-09-08-00044)
02-16-2011: Audit of Cooperativa de Seguros de Vida de Puerto Rico's Final Administrative Cost Proposal for Fiscal Year 2009 (A-02-10-01019)
02-14-2011: Review of Federal Reimbursement Claimed by North Carolina for Medicaid Personal Care Services Claims Submitted by Shipman Family Home Care, Inc. (A-04-09-04041)
02-11-2011: Review of Medicaid Excluded Providers in Iowa (A-07-10-03149)
02-07-2011: Review of Ohio's Payment Error Rate Measurement Corrective Action Plan (A-05-10-00063)
02-04-2011: Review of Medicaid Excluded Providers in Missouri (A-07-10-03153); Review of Medicare Claims for Home Blood-Glucose Test Strips and Lancets-Durable Medical Equipment Medicare Administrative Contractor for Jurisdiction D (A-09-08-00046)
02-03-2011: Review of Termination Costs Claimed by Cooperativa de Seguros de Vida de Puerto Rico (A-02-10-01028)
02-02-2011: Oversight of the Prescriber Identifier Field in Prescription Drug Event Data for Schedule II Drugs (A-14-09-00302)
01-31-2011: Review of Medicare Part A Bad Debts at Broughton Hospital for Fiscal Year Ended June 30, 2005 (A-04-09-04038); Review of Medicare Part A Bad Debts at John Umstead Hospital for Fiscal Year Ended June 30, 2005 (A-04-09-04034)
01-26-2011: Review of Alabama's Compliance With the Reserve or Rainy Day Fund Requirement for the Increased Federal Medical Assistance Percentage Under the American Recovery and Reinvestment Act (A-04-10-03058)
01-24-2011: Followup Review of Medicaid Cost-of-Care Overpayments Made to Nursing Facilities in the State of Maine (A-01-10-00008)
01-21-2011: Review of Medicare Claims for Home Blood-Glucose Test Strips and Lancets-Durable Medical Equipment Medicare Administrative Contractor for Jurisdiction C (A-09-08-00045)
01-20-2011: Review of High-Dollar Payments for Medicare Outpatient Claims Processed by TrailBlazer Health Enterprises, LLC, for the Period January 1, 2007, Through December 31, 2008 (A-06-10-00024)
01-19-2011: Reconciliation of North Carolina Division of Medical Assistance's Form CMS-64 for the Medicaid Family Planning Program (A-04-10-01092)
01-18-2011: Rollup Review of Impact on Medicare Program for Investment Income That Medicare Advantage Organizations Earned and Retained From Medicare Funds in 2007 (A-07-10-01080)
01-13-2011: Review of TrailBlazer Health Enterprises, LLC Payments for Inpatient Rehabilitation Facility Claims Billed with Patient Status Code 05 for Calendar Year 2007 (A-01-10-00500)
01-04-2011: Review of the Qualified Pension Plan at Cooperativa de Seguros de Vida de Puerto Rico, A Terminated Medicare Contractor, for the Period January 1, 2007, to December 31, 2008 (A-07-10-00343); Review of Pension Costs Claimed for Medicare Reimbursement by Cooperativa de Seguros de Vida de Puerto Rico for Fiscal Years 2007 Through 2009 (A-07-10-00342)
01-03-2011: Review of New York's Medicaid Rehabilitative Services Claims Submitted by Community Residence Providers (A-02-08-01006)

2010

12-28-2010: Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in Indiana for the Quarter Ending March 31, 2009 (A-05-09-00091); Audit of Cooperativa de Seguros de Vida de Puerto Rico's Final Administrative Cost Proposal for Fiscal Year 2008 (A-02-09-01031); Review of Jurisdiction 10 Payments for Inpatient Rehabilitation Facility Claims Billed with Patient Status Code 05 for Calendar Year 2007 (A-01-10-00517)
12-22-2010: Review of Health Maintenance Organization Controls Over Durable Medical Equipment Suppliers in Florida (A-04-10-07010); Review of Medicaid High-Dollar Payments for Inpatient Services in Illinois From January 1, 2006 Through September 30, 2007-Hospitals With Five or More High-Dollar Payments (A-05-09-00049); Review of Illinois' Prompt Pay Compliance Under the American Recovery and Reinvestment Act of 2009 From January 1, 2009, Through September 30, 2009 (A-05-09-00083); Review of American Recovery and Reinvestment Act of 2009: Medicaid Prompt Pay Requirements in New Hampshire (A-01-10-00009)
12-17-2010: Payments for Ambulatory Surgical Center Services Provided to Beneficiaries in Skilled Nursing Facility Stays Covered Under Medicare Part A in Calendar Years 2006 through 2008 (A-01-09-00521)
12-15-2010: Review of Washington State's Medicaid Claims for Nonqualified Aliens (A-09-09-00039)
12-14-2010: Review of Lahey Clinic's Claims for Outpatient Procedures That Included the Replacement of Medical Devices for Calendar Years 2007 and 2008 (A-01-10-00506)
12-13-2010: Review of Kansas's Compliance With the Federal Prompt Payment Requirements (A-07-10-01084)
12-06-2010: Review of Massachusetts General Hospital Claims for Outpatient Procedures That Included the Replacement of Medical Devices for Calendar Years 2007 and 2008 (A-01-10-00501)
12-03-2010: Review of Indiana Medicaid Intraoral Radiographs Paid in Excess of Reimbursement Limits During the Period January 1, 2009, Through December 31, 2009 (A-05-10-00070)
12-01-2010: Review of Colorado Medicaid Payments for Home Health Agency Claims Paid to Personal Assistance Services of Colorado (A-07-10-01087)
11-30-2010: Review of Yale New Haven Hospital Claims for Outpatient Procedures that Included the Replacement of Medical Devices for Calendar years 2007 and 2008 (A-01-10-00504)
11-19-2010: Review of UMass Memorial Medical Center Claims for Outpatient Procedures that Included the Replacement of Medical Devices for Calendar Years 2007 and 2008 (A-01-10-00503)
11-09-2010: Review of Colorado Medicaid Payments for Home Health Agency Claims (A-07-10-01083)
11-08-2010: Review of Selected Payments for Inpatient Services Processed by Noridian Administrative Services, LLC, for Calendar Years 2006 Through 2008 (A-07-10-04164); Review of Contract Signatures for the Hurricane Katrina Health-Care-Related Professional Workforce Supply Grant for the Greater New Orleans Area (A-06-09-00053)
11-04-2010: Review of Personal Care Services Provided by Tri-State Home Health and Equipment Services, Inc., in the District of Columbia (A-03-08-00207); Review of Sterilization Procedures in the Kansas Family Planning Program (A-07-10-04162)
11-03-2010: Verification of Mid Coast Hospital's Refund of Place-of-Service Overpayments for Calendar Years 2004-2007 (A-01-10-00523)
11-01-2010: Review of Terminated Drugs in the Medicare Part D Program (A-07-09-03130)
10-29-2010: Review of Medicare Contractor Payments for Neulasta Injections in Alaska, Arizona, and Washington for Calendar Years 2004 through 2007 (A-09-10-02044); Review of the Pension Segmentation Requirements for the Employees' Pension Plan at Wisconsin Physicians Service Insurance Corporation for the Period of January 1, 1989, to January 1, 2008 (A-07-10-00335)
10-28-2010: Review of Payments Exceeding Charges for Outpatient Services Processed by Wisconsin Physicians Service Insurance Corporation for Calendar Years 2004 Through 2007 (A-07-10-04167)
10-26-2010: Oversight and Evaluation of the Fiscal Year 2008 Payment Error Rate Measurement Program (A-06-09-00037); Review of Indiana's Reporting Fund Recoveries for Federal and State Medicaid Programs on the Form CMS-64 for Federal Fiscal Years 2000 Through 2008 (A-05-09-00021)
10-22-2010: Review of Nonemergency Medical Transportation Costs in the State of Texas (Transportation Provided by the League of United Latin American Citizens - Project Amistad) (A-06-09-00090)
10-20-2010: Review of Medicaid Personal Care Service Claims Submitted by Clarity Care, Inc., and Claimed by Wisconsin from July 1, 2006, Through June 30, 2008 (A-05-10-00019)
10-13-2010: Review of Resident Data Reported in the Intern and Resident Information System for Medicare Cost Reports Submitted to National Government Services Audit (A-02-09-01021); Review of Medicaid Personal Care Services Claims Made by Providers in New York State Audit (A-02-08-01005)
10-12-2010: Review of High-Dollar Payments for Medicare Outpatient Claims Processed by Pinnacle Business Solutions, Inc., for the Period January 1, 2007, Through December 31, 2008 (A-06-10-00034)
10-07-2010: Centers for Medicare & Medicaid Services' Use of Medicare Fee-for-Service Error Rate Data To Identify and Focus on Error-Prone Providers (A-05-08-00080); Review of Nebraska Medicaid Payments for Home Health Agency Claims Audit (A-07-09-01077)
10-05-2010: Review of Medicare Part B Carrier Payments for Neulasta Injections in California and Hawaii for Calendar Years 2004 Through 2007 Audit (A-09-10-02042)
10-01-2010: Review of California Transplant Donor Network's Reported Fiscal Year 2007 Organ Acquisition Overhead Costs and Administrative and General Costs Audit (A-09-09-00087)

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