Federal Reports

If a State taxes Medicaid managed care organizations (MCOs), the tax must extend to both Medicaid and non-Medicaid MCOs (i.e., be broad based) to comply with Federal requirements. At the time of our audit in 2016, two States did not meet Federal requirements stating that taxes on MCOs be broad based. Specifically, Ohio and Michigan continued to tax only Medicaid MCOs under their sales and use tax programs. Ohio stated that it would work with the Centers for Medicare & Medicaid Services (CMS) to address changes that might need to be made to its tax.

While continuing to fall, the overall rate of volume decline for letter mail has slowed substantially in recent years. Business-to-consumer mail like First-Class Mail Presort and Marketing Mail represents a growing portion of total mail volume – over 78 percent in 2015. There is substantial variation at the local, regional, and state levels in how much mail American adults send and receive, and how their use of mail has changed in recent years.