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Review of Florida�s Developmental Disabilities Medicaid Administrative Claiming Costs for the Period October 1, 2003, Through September 20, 2006

The Florida Agency for Health Care Administration (the Medicaid agency) did not always claim Developmental Disabilities Medicaid administrative claiming costs in accordance with Federal and State requirements. Based on our sample results of the random moment sampling system (RMSS) Medicaid-reimbursable strikes, we estimated that the Medicaid agency received Federal funding for $2.6 million in administrative costs that did not comply with Federal and State requirements during Federal fiscal years 2004 through 2006.

We recommended that the Medicaid agency strengthen existing procedures to ensure that all RMSS participants are sufficiently trained in RMSS procedures. We did not recommend recovery of the estimated overpayment because, although our stratified random sample was statistically valid, it did not identify a minimum of six errors per stratum as required by our statistical policy.

Filed under: Center for Medicare and Medicaid Services