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New York Did Not Ensure That Selected Medicaid Managed Care Organizations Complied With Mental Health and Substance Use Disorder Parity Requirements Related to Prior Authorization

Kansas Did Not Ensure That Its Medicaid Managed Care Organizations Complied With Mental Health and Substance Use Disorder Parity Requirements Related to Prior Authorization

Connecticut Generally Claimed Medicaid Reimbursement for Clinical Diagnostic Laboratory Services in Accordance With Federal and State Requirements

Georgia Claimed at Least $26.1 Million More in Medicaid Reimbursements for Clinical Diagnostic Laboratory Services Than Was Allowed by Federal and State Requirements

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

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

Florida Medicaid Fraud Control Unit: 2025 Inspection

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

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

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

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

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

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

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

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

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