Federal Reports

Arkansas did not always comply with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs. Arkansas did not invoice manufacturers for rebates associated with $9.9 million (Federal share) in physician-administered drugs. Of this amount, $8.5 million was for single-source drugs, and $1.4 million was for top-20 multiple-source drugs. Because Arkansas' internal controls did not always ensure that it invoiced manufacturers to secure rebates, Arkansas improperly claimed Federal reimbursement for these single-source drugs and top-20 multiple-source drugs.

This portfolio presents an overview of program vulnerabilities identified in prior Office of Inspector General audits, evaluations, investigations, and legal actions related to chiropractic services in the Medicare program. It consolidates the findings and issues identified in that work and discusses recommendations from prior reports that have not been implemented or have been implemented ineffectively. In addition, this portfolio provides information to help the Centers for Medicare & Medicaid Services understand the need for effective controls over chiropractic services and offers recommendations to help Medicare prevent fraud, waste, and abuse related to those services.

Notification of a Serious and Flagrant Problem and/or Deficiency in the Board's Administration of its Deliberative Process and the National Labor Relations Act with Respect to the Deliberation of a Particular Matter

CGS Administrators, LLC, did not claim allowable Medicare pension costs of $12,000 on its incurred cost proposals for calendar year 2011.

Palmetto Government Benefits Administrator, LLC, claimed unallowable Medicare pension costs of $95,000 for calendar years 2010 and 2011 on its incurred cost proposals.

Federal law requires that each Medicare administrative contractor (MAC) have its information security program evaluated annually by an independent entity, and these evaluations must address the eight major requirements enumerated in the Federal Information Security Management Act of 2002 (FISMA). To comply with this provision, CMS contracted with PricewaterhouseCoopers (PwC) to evaluate information security programs at the MACs using a set of agreed-upon procedures. The Office of Inspector General must submit to Congress annual reports on the results of these evaluations, to include assessments of their scope and sufficiency. This report fulfills that responsibility for fiscal year 2016.