Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Nebraska Medicaid Payments for Services Provided to Deceased Recipients During the Period October 1, 1998 Through June 30, 2000," (A-07-02-00145)

May 1, 2003


Complete Text of Report is available in PDF format (787 KB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

The objective of this review was to determine whether the state paid claims for deceased Medicaid recipients during the period of our review, and, if so, to determine the amount of the unallowable payments.  To accomplish our objective, we identified, using computer analysis, 1,140 claims totaling $72,311 that were potentially paid after the date of death.  Subsequently, we requested the state review these claims and determine if they were unallowable.  After reviewing the claims, the state confirmed that $16,229 (federal share $9,901) involving 141 claims were unallowable.  Also, the state referred six recipients with claims of $2,817 (federal share $1,722) to the state’s Surveillance and Utilization Review (SURS) Unit because false Social Security numbers were used to obtain eligibility for Medicaid.  The SURS has indicated they will pursue all claims relating to these ineligible individuals.