Department of Health

Medicaid Claims Paid in 2001 for Medicare Part A Eligible Recipients (Follow-Up Review)

Medicare is a federal health insurance program for the aged and the disabled; Medicaid is a joint state and federal health insurance program for the needy. If an individual is eligible for both Medicare and Medicaid, the individualís eligible medical costs are generally paid by Medicare. In our initial audit report 2000-D-1, we examined selected claims paid by Medicaid during 2001 on behalf of individuals who were eligible for both Medicaid and Medicare. We determined that as much as $20.9 million in Medicaid may have been overpaid, mainly because health care providers had not billed Medicare or had billed, and received duplicate payments from, both Medicare and Medicaid. We recommended that the Medicaid overpayments be investigated and recovered, and in our follow-up review, we found that investigation and recovery efforts had been initiated and some of the overpayments had been recovered.

For a complete copy of Report 2004-F-15 click here.