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California Made at Least $13.9 Million More in Medicaid Reimbursements for Clinical Diagnostic Laboratory Services Than Was Allowed by Federal and State Requirements

Community Behavioral Health Did Not Comply With Requirements When Denying Prior Authorization Requests

Lehigh Valley Hospital Received At Least $17.8 Million in Medicare Overpayments

CMS Should Improve Its Policies and Procedures for the Oversight of States’ Reported Medicaid Expenditures to Better Protect the Financial Integrity of the Medicaid Program

Connecticut Did Not Always Ensure Selected Nursing Homes Complied With Federal and State Background Check Requirements

Unclear Medicare Requirements Led to Differing Interpretations of Inpatient Rehabilitation Facility Documentation, Coverage, and Billing Requirements

Most Nursing Homes Throughout the United States Do Not Have Adequate or Reliable Emergency Power Systems

Medicare Payments for Positive Airway Pressure Devices Used for the Treatment of Obstructive Sleep Apnea Generally Complied With Medicare Requirements

CMS Could Strengthen Medicare Program Safeguards To Prevent and Detect Potentially Improper Payments for Virtual Check-in and E-visit Services

CMS Has Limited Oversight of Selected Compounded Drugs Prescribed to Medicare Part D Enrollees

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Priority Health (Contract H2320) Submitted to CMS

Louisiana Healthcare Connections Generally Complied With Federal and State Process Requirements When Denying Prior Authorization Requests

Selected Diabetes and Weight Loss Drugs Were Dispensed to Michigan Medicaid Managed Care Enrollees in Accordance With Federal and State Requirements

Medicare Home Health Agency Provider Compliance Audit: VNS Health

Indiana Generally Ensured That Selected Nursing Homes Complied With Federal Background Check Requirements

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Gateway Health Plan, Inc., (Contract H5932) Submitted to CMS

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Blue Cross and Blue Shield of Alabama (Contract H0104) Submitted to CMS

Emergency Department Procedure Codes Used on Medicare Claims for Services Billed With Nonemergency Department Sites of Service Resulted in Over $15 Million in Improper and Potentially Improper Payments

Sarasota Memorial Hospital Received At Least $12.1 Million in Medicare Overpayments

Colorado Made at Least $77.8 Million in Improper Fee-for-Service Medicaid Payments for Applied Behavior Analysis Provided to Children

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