Department of Health & Human Services

Source Id

395

An Ophthalmology Clinic in Florida: Audit of Medicare Payments for Eye Injections of Avastin, Eylea, and Lucentis

09/07/2021

2021

A-09-19-03025

Audit

Department of Health & Human Services OIG

Department of Health & Human Services

Why OIG Did This Audit Prior OIG work found that Medicare inappropriately paid for services that were billed as being distinct or significant and separately identifiable from other services provided on the same day. Our analysis showed that in 2018, an ophthalmology clinic in Florida (the Clinic)...

Read more about An Ophthalmology Clinic in Florida: Audit of Medicare Payments for Eye Injections of Avastin, Eylea, and Lucentis

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UPMC Health Plan, Inc. (Contract H3907) Submitted to CMS

11/05/2021

2022

A-07-19-01188

Audit

Department of Health & Human Services OIG

Department of Health & Human Services

Read more about Medicare Advantage Compliance Audit of Specific Diagnosis Codes That UPMC Health Plan, Inc. (Contract H3907) Submitted to CMS

Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health Care of Missouri, Inc. (Contract H2663) Submitted to CMS

10/28/2021

2022

A-07-17-01173

Audit

Department of Health & Human Services OIG

Department of Health & Human Services

Read more about Medicare Advantage Compliance Audit of Specific Diagnosis Codes That Coventry Health Care of Missouri, Inc. (Contract H2663) Submitted to CMS

Kentucky Made Almost $2 Million in Unallowable Capitation Payments for Beneficiaries With Multiple Medicaid ID Numbers

12/01/2021

2022

A-04-20-07094

Audit

Department of Health & Human Services OIG

Department of Health & Human Services

Read more about Kentucky Made Almost $2 Million in Unallowable Capitation Payments for Beneficiaries With Multiple Medicaid ID Numbers

Tennessee Medicaid Claimed Hundreds of Millions of Federal Funds for Certified Public Expenditures That Were Not in Compliance With Federal Requirements

10/19/2021

2022

A-04-19-04070

Audit

Department of Health & Human Services OIG

Department of Health & Human Services

Why OIG Did This Audit Under a Medicaid waiver, Tennessee was allowed to claim as certified public expenditures (CPEs) the uncompensated cost of care (UCC) at public hospitals for Medicaid enrollees and uninsured patients. During State fiscal years (SFYs) 2009 through 2014, Tennessee claimed a total...