Department of Health

Medicaid Payments to Referred Ambulatory and Laboratory Providers While Recipients Were Hospitalized (Follow-Up Report)

The daily Medicaid reimbursement rates for hospitalization generally cover the costs of all medical services provided to Medicaid recipients during their hospital stays. To determine whether ambulatory and laboratory service providers were inappropriately paid for services provided to Medicaid recipients during their hospital stays, in audit report 2006-S-90, we examined selected Medicaid payments to these providers over a five-year period. We identified more than $2.3 million in inappropriate payments and questioned additional payments of $622,937. We recommended that the Department of Health recover the overpayments and develop controls to prevent such overpayments in the future. When we followed up on these matters with Department officials, we found that they had implemented most of our audit recommendations.

For a complete copy of Report 2008-F-25 click here.
For a copy of the 90-day response click here.