Department of Health

Inappropriate Medicaid Payments for Services to Persons with Developmental or Psychiatric Disabilities

The cost of some of the services provided by the facilities and community-based providers operated or overseen by the Office of Mental Health and the Office of Mental Retardation and Developmental Disabilities may be reimbursed by Medicaid. We examined the payments made by Medicaid for such services over a four-and one-half year period and identified overpayments totaling as much as $4.4 million. Most of these overpayments were duplicate payments that could have been prevented by standard automated claims processing controls. Other overpayments were made because certain records containing information about the patientsí Medicaid eligibility status were not updated in a timely manner. We recommended that the payments be investigated, all overpayments be recovered, and controls be improved to prevent such overpayments in the future.

For a complete copy of Report 2000-S-31 click here.
For a copy of the 90-day response click here.