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Audit (A-06-10-00057)

01-05-2012
Review of Oklahoma Collections for the Medical Assistance Program for Calendar Years 2004 Through 2009

Executive Summary

From January 1, 2004, through December 31, 2009, the State agency did not accurately report all of the collections on the CMS-64 reports. The State agency reported collections of $714.2 million ($492.2 million Federal share) but should have reported $729.6 million ($507 million Federal share). The State agency did not report collections of $15.4 million ($10.9 million Federal share) and underreported the Federal share of collections by $3.9 million.

Additionally, we set aside $435,000 in adjusted claims that the State agency could not support.

We recommended that the State agency (1) refund to the Federal Government $14.8 million; (2) work with CMS to determine what portion of the $435,000 in unsupported adjusted claims should be used to decrease medical assistance expenditures; (3) ensure that records supporting collections reported on the CMS-64 report are maintained and readily available; and (4) establish review procedures to ensure that collections are correctly compiled, assigned, and reported on the CMS-64 report. The State agency agreed with three of the four recommendations but disagreed with our recommendation to work with CMS to determine what portion of the $435,000 in unsupported adjusted claims should be used to decrease medical assistance expenditures.

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