Department of Health
Medicaid Claims Processing Accuracy for the Year Ended March 31, 2004 (Follow-Up Report) 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. As is noted in audit report 2003-S-60, during the year ended March 31, 2004, these weekly examinations found that health care providers were overpaid as much as $32.5 million in Medicaid. We recommended that these payments be investigated and all overpayments recovered. When we followed up on our recommendations, we found that some progress had been made in the investigation and recovery of overpayments.
For a complete copy of Report 2005-F-21 click here.