Department of Health and Human Services

Office of Inspector General -- AUDIT

"Medicaid Payments for Services Provided to Beneficiaries With Concurrent Eligibility in Illinois and Indiana for July 1, 2005, Through June 30, 2006 - Illinois Department of Healthcare and Family Services," (A-05-06-00069)

January 17, 2008


PDF File Complete Text of Report is available in PDF format (2.17 mb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

The objective of our review was to determine whether the Illinois Department of Healthcare and Family Services (the State agency) made payments on behalf of beneficiaries who should not have been Medicaid-eligible due to their eligibility in Indiana.  For the period July 1, 2005, through June 30, 2006, we estimate that the State agency paid $408,841 ($204,420 Federal share) for Medicaid services provided to beneficiaries who should not have been eligible due to their Medicaid eligibility in Indiana.  The Medicaid payments were made on behalf of these beneficiaries because the State agency and Indiana’s Medicaid agency did not share all available Medicaid eligibility information. 

We recommended that the State agency work with the Indiana Medicaid agency to share available Medicaid eligibility information for use in (1) determining accurate beneficiary eligibility status and (2) reducing the amount of payments, estimated to be $408,841 ($204,420 Federal share), made on behalf of beneficiaries residing in Indiana.  The State agency agreed with the recommendations.