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Audit (A-04-14-08028)

09-09-2014
Washington Received Millions in Unallowable Bonus Payments

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Summary

Under the Children's Health Insurance Program Reauthorization Act of 2009, Congress appropriated $3.225 billion for qualifying States to receive performance bonus payments (bonus payments) for Federal fiscal years (FYs) 2009 through 2013 to offset the costs of increased enrollment of children in Medicaid.

Some of the bonus payments that Washington received for the audit period were not allowable in accordance with Federal requirements. Most of the data used in Washington's bonus payment calculations was in accordance with Federal requirements. However, the State agency overstated its FYs 2009 through 2012 current enrollment in its bonus requests to CMS because it included individuals who did not qualify because of their basis-of-eligibility code. As a result, CMS overpaid Washington $19.5 million in bonus payments. We recommended that the State agency (1) refund $19.5 million to the Federal Government and (2) ensure that future requests for CHIPRA bonus payments include only qualifying children to comply with Federal requirements. The State agency disagreed with our findings.

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Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201