Department of Health

Medicaid Managed Care Payments for Newborn Services (Follow-Up Report)

The Department of Health pays managed care organizations a fixed monthly capitation premium for each individual enrolled in the Medicaid Managed Care program. This monthly premium is increased for infants during the first six months of their life. In audit report 2004-S-68, we examined the special six-month premiums paid by the Department over a four-year period and found that they were generally appropriate. We did identify $551, 029 in overpayments, which we recommended that the Department recover. When we followed up on this recommendation, we found that the Department was in the process of recovering the overpayments.

For a complete copy of Report 2006-F-28 click here.