U.S. Department of Health & Human Services

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1. Data inadequacies undermine CMS's oversight of the inconsistency resolution process for the federal marketplace


2. CMS validated hospital inpatient quality reporting program data, but should use additional tools to identify gaming


4. Enhancements needed in the tracking and collection of Medicare overpayments identified by ZPICS and PSCS


7. Medicare payments for clinical diagnostic laboratory tests in 2016: year 3 of baseline data


8. Excluding noncovered versions when setting payment for two Part B drugs would have resulted in lower drug costs for Medicare and its beneficiaries


9. Followup review: CMS's management of the quality payment program


10. Potential misclassifications reported by drug manufacturers may have led to $1 billion in lost Medicaid rebates


11. CMS did not detect some inappropriate claims for durable medical equipment in nursing facilities


12. Opioids in Ohio Medicaid: review of extreme use and prescribing


15. Questionable billing for compounded topical drugs in Medicare Part D


17. Medicare Advantage appeal outcomes and audit findings raise concerns about service and payment denials