Department of Health

Managed Care Payments for Newborn Services

The Department of Health pays managed care organizations a fixed monthly capitation premium for each individual enrolled in the Medicaid Managed Care program. This monthly premium is increased during the first six months of an infantís life to cover costs typically incurred at this time. We examined the special six-month premiums paid by the Department over a four-year period and found that they were generally appropriate. We did identify $551, 029 in overpayments, which we recommended that the Department recover.

For a complete copy of Report 2004-S-68 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.