Department of Health

Inappropriate Medicaid Claims for Newborn Services (Follow-Up)

Newborn infants with low birth weights require higher levels of care. Accordingly, the Medicaid reimbursement rates for such infants are higher than the rates for infants with normal birth weights. In audit report 2008-S-152, we examined selected Medicaid payments for services provided to newborn infants and identified overpayments of $480,894. The overpayments were made because the claims submitted by the medical providers erroneously understated the infants’ birth weights. When we followed-up with Department of Health officials, we found they have made some progress in correcting the problems we identified in our initial report. However, improvements were still needed.

For a complete copy of Report 2010-F-43 click here.