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Audit (A-02-11-01004)

04-17-2012
Review of the Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program in the U.S. Virgin Islands for the Quarter Ended September 30, 2009

Executive Summary

The U.S. Virgin Islands (Virgin Islands) Department of Health's (DOH) claims for Federal reimbursement of Medicaid expenditures for the quarter ended September 30, 2009, were not adequately supported by actual recorded expenditures. Of the $6.5 million ($3.2 million Federal share) in Medicaid expenditures that we reviewed, DOH improperly claimed $787,000 ($393,000 Federal share) for expenditures that were improperly calculated because DOH had not established policies and procedures for preparing the Form CMS-64.

The American Recovery and Reinvestment Act of 2009 provided additional Medicaid funding based on temporary increases in the Virgin Islands' Federal medical assistance percentage.

We recommended that DOH (1) refund $393,000 to the Federal Government and (2) establish policies and procedures for preparing the Form CMS-64. DOH partly agreed and partly disagreed with our recommendations.

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