Federal Reports

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Medical Ambulance Services, Inc. (MAS), located in San Juan, Puerto Rico, claimed Medicare Part B reimbursement for ambulance services that did not comply with Federal and Commonwealth of Puerto Rico requirements. Of the 100 claims in our random sample, 5 complied with Federal and Commonwealth requirements, but 95 did not. Of these, 40 contained more than 1 deficiency.

CGS Administrators, LLC, claimed unallowable Medicare pension costs of $1,200 for Medicare reimbursement for fiscal years 2008 through 2011.

CGS Administrators, LLC, claimed $23,000 of unallowable Medicare pension costs on its Incurred Cost Proposals for calendar years 2010 and 2011.

CGS Administrators, LLC, did not claim $6,000 of allowable Medicare postretirement benefit costs that on its Incurred Cost Proposals for calendar years 2010 and 2011.

The House Committee on Energy and Commerce's Subcommittee on Oversight and Investigations and Subcommittee on Health requested that the U.S. Department of Health and Human Services, Office of Inspector General, provide information regarding the Centers for Medicare & Medicaid Services' (CMS) automated system for processing financial assistance payments (e.g., advance premium tax credits and cost-sharing reductions). This briefing document presents our initial review of the design and implementation of CMS's automated system from May 1 through October 31, 2016. As of May 2016, CMS has fully implemented the automated system for the Federal marketplace and plans to fully transition issuers operating through State marketplaces to the automated system in 2018.