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South Carolina Did Not Always Accurately Report and Refund the Federal Share of Medicaid Collections for July 1, 2011, Through December 31, 2012

For the audit period, the South Carolina Department of Health and Human Services (State agency) generally accurately reported Medicaid collections on its CMS-64s. Of about $306 million in total collections, the State agency accurately reported and refunded the Federal share on about $294 million; however, it did not accurately report or refund the Federal share on about $12 million in collections related to third-party liability claims and program integrity recoupments. For these collections, the State agency used the current Federal medical assistance percentage (FMAP), instead of the FMAP in effect at the time that the Federal Government matched the original expenditure, to calculate the Federal share to be refunded. As a result, the State agency underreported $445,000 Federal share of collections to be refunded to the Federal Government.

Filed under: Center for Medicare and Medicaid Services