A recent report published by the Office of the Inspector General showed the Medicaid program pays significantly less than Medicare for drugs. The OIG compared the prices paid (including rebates) for ...

Medicare Advantage organizations may be improperly using health risk assessments to increase risk-adjusted reimbursement, according to a report HHS’ Office of Inspector General issued in September.

Network adequacy remains a significant challenge for behavioral healthcare in Medicare Advantage (MA) and Medicaid managed care, according to a new report. Analysts at the Department of Health and ...

The Office of the Inspector General (OIG) has been cracking down recently on Medicare overpayments to hospitals. Following an audit report done on March 13, OIG found that Boston's Brigham and Women's ...

A recent Department of Health and Human Services Office of Inspector General (OIG) report also found that Medicare Advantage ...

A federal watchdog said Tuesday it has begun auditing nursing homes’ use of the Patient Driven Payment Model to drive skilled nursing reimbursement, and the first targeted facility is blasting the ...

The OIG did not determine the accuracy of the Medicare RAC’s improper payment decisions, but argued that the Centers for Medicare & Medicaid Services could do a better job evaluating it’s own efficacy ...

The CMS could use its competitive bidding program to address price concerns, after payments for the devices swelled over five years, the government watchdog said. Medicare first started covering CGMs ...

The Office of Inspector General has released a report examining prior authorization patterns from seven managed care companies, and based on the findings is urging increased oversight of prior ...