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Colorado Could Improve Its Electronic Visit Verification System and Claimed Federal Medicaid Reimbursement for Millions of Dollars in Personal Care Services That Did Not Comply With Federal and State Requirements

States Have Missed Some Opportunities to Improve Medicaid Managed Care Organizations’ Provider Fraud Referrals

Novitas Solutions, Inc., Improperly Paid Approximately $19.5 Million for Selected Medicare Part B Services Provided to Patients Residing in Nursing Homes

The National Institutes of Health Administered Superfund Appropriations During Fiscal Year 2025 in Accordance With Federal Requirements

Spring 2026 Semiannual Report to Congress

New York Should Improve Its Oversight of Nursing Homes’ Compliance With Background Check Requirements

Part D Plans Generally Include Drugs Commonly Used by Dual-Eligible Enrollees: 2026

Florida Medicaid Fraud Control Unit: 2025 Inspection

Medicare Could Have Saved $255.1 Million Related to Hospice Services for Certain New Hospice Enrollees

CMS’s Processes Were Not Effective in Ensuring the Accuracy of Staffing Information Reported in the Payroll-Based Journal

Jefferson Regional Medical Center Received at Least $4.7 Million in Medicare Overpayments

North Dakota Could Better Ensure That Providers Fully Comply With Federal Waiver and State Health, Safety, and Administrative Requirements at 44 Residential Settings

A Small Southeastern Hospital Had Effective Cybersecurity Controls To Prevent, Detect, and Respond To Cyberattacks

Inaccurate Medicaid Managed Care Provider Directories May Limit Enrollees’ Access to Maternal Health Care

Inaccurate Medicaid Managed Care Network Lists May Compromise State Oversight of Access to Maternal Health Care

Congressional Mandate: Part B Billing Codes for Six Drugs Included Noncovered Self-Administered Versions During January 2025 - March 2026

The Three Largest Medicare Advantage Organizations Denied Requests for Long-Term Acute Care and Inpatient Rehabilitation at Some of the Highest Rates

Medicare Advantage Organizations Overturned Nearly All Appealed Prior Authorization Denials for Skilled Nursing Facility Admission, Raising Concerns About Initial Denials

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

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