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Review of Medicaid Services to Incarcerated Juveniles in the State of Georgia for Federal Fiscal Years 2003 and 2004

For Federal fiscal years (FY) 2003 and 2004, the Medicaid agency inappropriately claimed $3.8 million ($2.3 million Federal share) in costs relating to non-inpatient medical services provided to juvenile inmates of public institutions because neither the Georgia Department of Juvenile Justice (DJJ) nor the Medicaid agency had adequate controls to ensure that those services were excluded from Federal financial participation. We recommended that the Medicaid agency refund the $2.3 million overpayment, identify and refund subsequent overpayments, and establish monitoring procedures to ensure the accuracy of Medicaid eligibility status codes.

In written comments on the draft report, the Medicaid agency requested we delay the release of our report until April 6, 2009, to give it �the opportunity to review each claim considered �erroneously reimbursed.�� We delayed issuance of our report; however, neither DJJ nor the Medicaid agency provided additional support for their assertion that juveniles voluntarily residing at the institutions were included in our overpayment calculation.

Filed under: Center for Medicare and Medicaid Services