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  • Part D Sponsors Reporting of Direct and Indirect Remunerations
    CMS requires that Part D sponsors submit DIR reports for use in the payment reconciliation process We will determine whether Part D sponsors complied with Medicare requirements for reporting DIR
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    Do not use your browser’s back button during the search; instead, use the navigation features on the LEIE webpage Other search tips can be found on our tips page
  • Medications for Opioid Use Disorder in Medicare in 2023: Annual Review
    The opioid crisis remains a public health emergency In 2023, an estimated 81,842 opioid-related overdose deaths occurred in the United States Ensuring both that patients who would benefit from treatment for opioid use disorder have access to this treatment and that people have opioid overdose-reversal drugs on hand are key to addressing this crisis This data brief, Medications for Opioid
  • Hospitals Billing for Severe Malnutrition on Medicare Claims
    Hospitals Billing for Severe Malnutrition on Medicare Claims Many elderly Medicare patients, especially those who are severely ill, are malnourished Malnutrition can result from the treatment of another condition, inadequate treatment or neglect, or the general deterioration of a patient's health Medicare sets forth a number of Federal requirements, including the Social Security Act § 1862
  • Potentially Preventable Hospitalizations of Medicare-Eligible Skilled . . .
    Prior OIG work identified nursing facilities with high rates of Medicaid enrollee transfers to hospitals for a urinary tract infection (UTI), a condition that is often preventable and treatable in the nursing facility setting without requiring hospitalization The audits disclosed that the nursing facilities often did not provide UTI prevention and detection services in accordance with its
  • Medicare Market Shares for Diabetic Testing Strips from April to June 2019
    Section 50414 of the Bipartisan Budget Act of 2018 amended section 1847 (b) (10) (A) by requiring that, for bids to furnish DTS on or after January 1, 2019, CMS must use both mail order and non-mail order data when assessing compliance with the 50-percent rule
  • Review of HHS Government Purchase, Travel, and Integrated Charge Card . . .
    The Charge Card Act requires IGs to use the risk assessments to determine the necessary scope, frequency, and number of IG audits or reviews of the charge card programs It requires Federal agencies to establish and maintain safeguards and internal controls for purchase cards, convenience checks, travel cards, and integrated cards
  • National Background Check Program for Long Term Care Providers . . .
    National Background Check Program for Long Term Care Providers: Assessment of State Programs Concluded in 2017 and 2018 The Patient Protection and Affordable Care Act (ACA) authorizes CMS to provide grants to States to implement background check programs for prospective employees and providers of long-term-care services The ACA requires OIG to evaluate this grant program, known as the
  • Data Brief: Early Results from the Opioid State Targeted Response Grants
    The majority of funds must be used for opioid treatment services using clinically appropriate evidence-based practices, particularly the use of medication assisted treatment We will review early results of the Opioid STR grants
  • Hyperbaric Oxygen Therapy (HBO) Services - Provider Reimbursement in . . .
    Hyperbaric Oxygen Therapy (HBO) Services - Provider Reimbursement in Compliance with Federal Regulations Hyperbaric oxygen (HBO) therapy involves giving a beneficiary high concentrations of oxygen within a pressurized chamber in which the beneficiary intermittently breathes 100 percent oxygen HBO therapy is primarily an adjunctive treatment for the management of select nonhealing wounds In





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