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Audit (A-07-12-03178)

11-20-2012
Iowa Did Not Properly Pay Some Medicare Part A and Part B Deductibles and Coinsurance

Executive Summary

We found that the Iowa Department of Human Services (State agency) claimed unallowable Medicaid payments of $211,000 ($148,000 Federal share) during fiscal year 2011. The State agency did not always claim Medicaid payments for Medicare Part A and Part B deductibles and coinsurance in accordance with Federal requirements and the approved State plan.

We recommended that the State agency (1) refund $148,000 to the Federal Government and (2) ensure that Medicaid payments for Medicare Part A and Part B deductibles and coinsurance are allowable under Federal requirements and the approved State plan, specifically by limiting (a) enrollment to eligible persons and (b) payments to allowable services. The State agency concurred with our findings and recommendations.

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