Department of Health

Controls Over Supplemental Maternity Payments

The Department of Health pays managed care organizations a fixed monthly capitation premium for each individual enrolled in the Medicaid Managed Care and Family Health Plus programs. In addition, the Department makes special one-time supplemental maternity payments to cover the costs of pre-natal care, delivery and post-partum care. We examined the Departmentís controls over these supplemental maternity payments and found that improvements were needed, as we identified at least $1.6 million in duplicate payments and payments made on behalf of ineligible individuals. We also found that payments were sometimes miscoded, and as a result, State and county shares of program costs were incorrectly calculated.

For a complete copy of Report 2004-S-67 click here.
For a copy of the 90-day response click here.