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A Brooklyn chiropractor received at least $672,000 over 2 years for chiropractic services that were not allowable in accordance with Medicare requirements.
The Maine Department of Health and Human Services (State agency) did not comply with Federal Medicaid waiver and State requirements for reporting and monitoring critical incidents involving Medicaid beneficiaries with developmental disabilities residing in community residences. The State agency did...
Head Start grantees are required to have Single Audits conducted in accordance with the Office of Management and Budget Circular A 133 (also known as A-133 audits) for fiscal years beginning before December 26, 2014. The Administration for Children and Families (ACF) had a process in place to ensure...
TrailBlazer Health Enterprises, LLC, did not claim $4.3 million of allowable Medicare pension costs on its Final Administrative Cost Proposals for fiscal years 2005 through 2011.
TrailBlazer Health Enterprises, LLC (TrailBlazer), understated the Medicare segment pension assets by $1.2 million as of April 30, 2013. In addition, TrailBlazer understated Medicare's share of the Medicare segment excess pension assets by $1.2 million as of April 30, 2013, as a result of the...
The State agency did not adequately oversee its Medicaid Nonemergency Medical Transportation (NEMT) brokerage program to ensure that Federal and State requirements and contract provisions were met. Specifically, Oklahoma's oversight and monitoring of its Medicaid NEMT brokerage program did not...
Some hospitals in Medicare Jurisdiction F did not always claim Medicare graduate medical education (GME) reimbursement for residents in accordance with Federal requirements. Specifically, we found that 41 hospitals claimed residents for the same period as more than 1 full-time equivalent (FTE) on...
The State agency ensured that allegations and referrals of abuse and neglect for children in foster care covered by Title IV-E of the Act were recorded, investigated, and resolved in accordance with State requirements as required by Federal law.
Of the $5.7 million in Low-Income Home Energy Assistance Program (LIHEAP) grant funds that the Administration for Children and Families awarded to the Three Affiliated Tribes (TAT) for Federal fiscal years 2010 through 2014, TAT did not administer LIHEAP grant funds totaling $1.2 million in...
Private health insurers, Medicare Advantage plans, and Medicare Part D sponsors are required to spend a fixed percentage of premium dollars to provide medical services and health quality improvement activities. This percentage is known as a medical loss ratio (MLR).
