Department of Health

Medicaid Claims Paid in 1999 for Medicare Part A Eligible Recipients (Follow-Up Review)

Medicare is a federal health insurance program for the aged and the disabled; Medicaid is a joint state and federal health insurance program for the needy. If an individual is eligible for both Medicare and Medicaid, the individualís eligible medical costs are generally paid by Medicare. In our prior report 2000-D-4, we examined selected claims paid by Medicaid during 1999 on behalf of individuals who were eligible for both Medicaid and Medicare. We determined that as much as $12.9 million in Medicaid may have been overpaid, mainly because health care providers had not billed Medicare or had billed, and received duplicate payments from, both Medicare and Medicaid. We recommended that the Medicaid overpayments be investigated and recovered. In our follow-up review, we found that this recommendation had not been implemented.

For a complete copy of Report 2002-F-2 click here.
For a copy of the 90-day response click here.