Department of Health

Medicaid Overpayments of Coinsurance Fees for Medicare Beneficiaries (Follow-Up)

If an individual is eligible for both Medicare and Medicaid, the individual's eligible medical costs are to be paid by Medicare, except for a portion of the costs relating to certain services, which are to be paid by Medicaid. In audit report 2008-S-128, we examined the payments made by Medicaid over a one-year period on behalf of individuals who were eligible for both Medicare and Medicaid to determine whether any overpayments had been made because medical service providers had inaccurately reported the amounts they had been paid by Medicare. We identified an estimated $2.7 million in such overpayments. When we followed up with Department of Health officials, we found that they made significant progress in correcting the problems we identified in our initial report.

For a complete copy of Report 2011-F-11 click here.