Department of Health

Medicaid Payments to Office of Mental Health and Office of Mental Retardation and Developmental Disabilities Providers While Recipients Were Hospitalized (Follow-Up Report)

Many of the clients served by the Office of Mental Health and the Office of Mental Retardation and Developmental Disabilities receive services in community-based settings. Some of these services are eligible for Medicaid reimbursement. In audit 2006-S-89, we examined selected Medicaid payments for such services over a five-year period and identified more than $2.4 million in inappropriate payments. The payments were inappropriate because, in some instances, the services were not eligible for reimbursement, and in other instances, the clients were hospitalized and had not been in a community-based setting for a sufficient period of time to qualify for reimbursement. 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 made some progress in their implementation of our audit recommendations, but additional actions still needed to be taken.

For a complete copy of Report 2008-F-32 click here.
For a copy of the 90-day response click here.