U.S. flag

An official website of the United States government

Dot gov

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Medicaid Long-Term Care Payments for Individuals with Both Medicare and Medicaid Coverage," (A-06-03-00040)

March 31, 2004

Complete Text of Report is available in PDF format (242 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


Based on a statistical sample, we estimated that the Texas Department of Human Services (Department) made incorrect Medicaid payments of at least $12,879 during the period January 1, 2001 through June 30, 2001 on behalf of dual eligible individuals which included payments for regular nursing and Medicare co-insurance.  Medicaid overpayments occurred because nursing facilities failed to send the appropriate Medicare skilled nursing facility (SNF) admission and discharge information to the Department.  We are recommending that the Department refund $7,801, which is the Federal share of our estimate of at least $12,879 in overpayment; strengthen controls concerning the accuracy of the SNF admission and discharge information; and work with the  Centers for Medicare and Medicaid Services to prevent incorrect payments.