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Audit (A-03-09-00203)

Review of Maryland’s Claims Associated With the Increased Federal Medical Assistance Percentage Under the American Recovery and Reinvestment Act of 2009

Executive Summary

Our review found that the Maryland Department of Health and Mental Hygiene’s (the State agency) $276 million in claims associated with the temporarily increased Federal medical assistance percentage (FMAP) was computed using the Medicaid expenditure base specified in the American Recovery and Reinvestment Act of 2009, P.L. No. 111-5 (Recovery Act), and the expenditures were supported by the State agency’s accounting records. The Recovery Act provides, among other initiatives, fiscal relief to States to protect and maintain State Medicaid programs in a period of economic downturn. For the recession adjustment period (October 1, 2008, through December 31, 2010), the Recovery Act provides an estimated $87 billion in additional Medicaid funding based on temporary increases in States’ FMAPs.

In addition, the State agency had policies and procedures in place to segregate Medicaid expenditures that qualified for the temporarily increased FMAP and to ensure that those Medicaid expenditures that did not qualify were not being claimed for reimbursement at the temporarily increased FMAP.

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