Department of Health

Controls Over Supplemental Maternity Payments (Follow-Up Report)

The Department of Health pays managed care organizations a fixed monthly capitation premium for each individual enrolled in the Medicaid Managed Care program and the Family Health Plus program. In addition, the Department makes special one-time supplemental maternity payments to cover the costs of pre-natal care, delivery and post-partum care. In audit report 2004-S-67, 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. When we followed up on our audit recommendations, we found that they had been implemented by Department officials.

For a complete copy of Report 2006-F-31 click here.