Department of Health and Human Services

Office of Inspector General -- AUDIT

"Medicaid Payments for Services Provided to Beneficiaries With Concurrent Eligibility in Arizona and California for July 1, 2005, Through June 30, 2006 - Arizona Health Care Cost Containment System," (A-05-07-00057)

May 5, 2008


PDF File Complete Text of Report is available in PDF format (1.84 mb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

For the period July 1, 2005, through June 30, 2006, we estimated that Arizona paid approximately $500,000 ($335,000 Federal share) for Medicaid services provided to beneficiaries who should not have been eligible owing to their Medicaid eligibility/residence in California.  Both Arizona and California require that Medicaid beneficiaries be residents.

We recommended that Arizona work with the California Medicaid agency to share available Medicaid eligibility information for use in determining accurate beneficiary eligibility status and reducing the amount of payments, estimated to be approximately $500,000 ($335,000 Federal share), made on behalf of beneficiaries residing in California.  Arizona acknowledged its obligation to review beneficiaries’ eligibility and identified several issues that it believed would reduce the reported payments.  We reviewed Arizona’s comments and maintain that our findings remain valid.

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