Department of Health

Medicaid Overpayments of Coinsurance Fees for Medicare Beneficiaries

If an individual is eligible for both Medicare and Medicaid, the individual's eligible medical costs are to be paid by Medicare, except for a portion of the costs relating to certain services, which are to be paid by Medicaid. We examined the payments made by Medicaid over a one-year period on behalf of individuals who were eligible for both Medicare and Medicaid to determine whether any overpayments had been made because medical service providers had inaccurately reported the amounts they had been paid by Medicare. We identified an estimated $2.7 million in such overpayments. We recommended that the overpayments be investigated and recovered.

For a complete copy of Report 2008-S-128 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.