Department of Health

Medicaid Claims Processing Accuracy for the Year Ended March 31, 2000 (Follow-Up Review)

In our prior report 99-D-2, it was noted that, during the year ended March 31, 2000, health care providers were overpaid as much as $34.4 million in Medicaid, primarily because third-party insurance coverage was not taken into account, claim forms were incorrectly completed by providers, or the reimbursed treatment may not have been medically necessary. We recommended that the overpayments be recovered. In our follow-up review, we found that some of the overpayments had been recovered, but action had yet to be initiated to investigate and recover $13 million of the potential overpayments.

For a complete copy of Report 2001-F-46 click here.
For a copy of the 90-day response click here.