The Department of Health and Human Services Office of Inspector General (OIG) released an audit on July 20, 2026, finding that one Medicare Administrative Contractor (MAC), Novitas Solutions, improperly paid an estimated $19.5 million for certain Medicare Part B services furnished to beneficiaries residing in nursing homes.

The audit reviewed claims for the period from October 1, 2018, through September 30, 2019, for evaluation and management, psychotherapy, and podiatry services and found that 91 of the 150 sampled claims did not meet Medicare requirements or documentation standards. Based on those findings, OIG estimated that millions of dollars in payments were made for services that should not have been reimbursed. The report focused on Novitas’ oversight of claims in one of its jurisdictions rather than on nursing homes themselves, but it underscores continued federal scrutiny of Medicare billing and documentation practices in post-acute and long-term care settings. The OIG recommended that Novitas strengthen its claims review processes to prevent future improper payments and provide annual education to providers and their billing staff specific to the Medicare requirements.

Providers should expect ongoing attention from regulators and Medicare contractors on documentation supporting Part B services furnished to nursing home residents.