Department of Health

Medicaid Overpayments for Medicare Part B 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 (called Part B services), which are to be paid by Medicaid. We examined selected payments made by Medicaid for a one-year period on behalf of individuals who were eligible for both Medicare and Medicaid. We identified an estimated $1.8 million in overpayments to medical providers that incorrectly billed Medicaid for Medicare Part B services. In many instances, the providers either double-billed the services or did not accurately report Medicare payment information on their Medicaid claims. We recommended that the overpayments be investigated and recovered, and procedures be established for preventing such overpayments in the future.

For a complete copy of Report 2008-S-63 click here.
For a copy of the 90-day response click here.
For a copy of the associated follow-up report click here.