Department of Health

Medicaid Claims Processing Accuracy for the Year Ended March 31, 2001 (Follow-Up Review)

The Medicaid Management Information System (MMIS) is a centralized, automated medical assistance information and payment system that is operated by a fiscal agent under a contract with the Department of Health. The State Comptroller maintains audit staff on site to conduct continuous audits of the MMIS, including weekly examinations of the accuracy of the Medicaid claims that are processed. Our prior report 2000-D-1, noted that, during the year ended March 31, 2001, these weekly examinations found health care providers were overpaid as much as $38.3 million. We recommended that these payments be investigated and all overpayments recovered. In our follow-up review, we found that progress had been made in the investigation and recovery of overpayments, but $14.7 million in overpayments had yet to be recovered.

For a complete copy of Report 2003-F-30 click here.
For a copy of the 90-day response click here.