Data & Reports
Avalere Health
CMI Trend Reports- Identifying The Top 5 CMS-Approved Medicare Billing Issue Areas That Put Taxpayer Dollars At Risk
- States & Medicare Waste
- 2016 State Of The RAC Program
- A Look at Medicare Improper Payments in Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
CMS RAC Report to Congress
HHS Agency Financial Reports
CERT reports, Medicare Fee-For-Service Improper Payments
- FY2016 Report
- FY2016 Appendices
- FY2015 Report
- FY2015 Appendices
- FY2014 Report
- FY2014 Appendices
- FY2013 Report
- FY2013 Appendices
- FY2012 Report
- FY2012 Appendices
- FY2011 Report
- FY2011 Appendices
GAO Reports
- Medicare Claim Review Programs Could Be Improved with Additional Prepayment Reviews and Better Data
- MEDICARE PROGRAM INTEGRITY Greater Prepayment Control Efforts Could Increase Savings and Better Ensure Proper Payment
- Reducing Improper Payments Government Wide
- Government Efficiency and Effectiveness
- Medicare Fee-For-Service: Opportunities Remain To Improve Appeals Process
OIG Reports
- OIG 2017 Compendium of Unimplemented Recommendations
- OIG: Hospital Compliance Reports
- OIG: Medicare Recovery Audit Contractors And CMS’s Actions To Address Improper Payments, Referrals Of Potential Fraud, And Performance (August 2013)
- Podcast
- OIG: The First Level of the Appeals Process 2008-2012: Volume, Outcomes, and Timeliness (October 2013)
Medicare Trustees Report
CMI Letters to the Administration:
Other Resources:
- HHS Status Report on the State of the Medicare appeals backlog (January 2019)
- Memorandum Opinion of the US District Court in the AHA vs. HHS lawsuit (November, 2018)
- HHS Brief: American Hospital Association v Alex Azar (August 2018)
- Testimony of Gene L. Dodaro, Comptroller General of the U.S. before the Committee on the Budget, U.S. House of Representatives (May 2017)
- Memorandum Opinion: American Hospital Association v. Sylvia M. Burwell (December 2016)
- HHS Brief: American Hospital Association v. Sylvia M. Burwell (November, 2016)
- Senate Finance Testimony of the Honorable Nancy Griswold, Chief Administrative Law Judge, OMHA (April 2015)
- Statement of Work for the Recovery Audit Program
- HHS Primer on Medicare Appeals