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Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of Utah's Accounts Receivable System for Medicaid Provider Overpayments," (A-07-04-03051)

August 19, 2004


Complete Text of Report is available in PDF format (414 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


EXECUTIVE SUMMARY:

The objective of this audit was to determine whether the State agency reported Medicaid provider overpayments according to Federal regulations.  We found that the State agency did not report 93 Medicaid provider overpayments totaling $420,415 (Federal share) to CMS in accordance with Federal regulations.  As of March 31, 2004, seven of those overpayments, totaling $22,492 (Federal share), remained unreported.  The State agency did not always follow established policies and procedures.  Furthermore, its policies and procedures were not sufficient to ensure the timely reporting of all overpayments.  We recommended that the State Agency (1) refund the Federal share of overpayments to the Federal Government, and (2)  strengthen policies and procedures to ensure all overpayments are reported in accordance with Federal regulations.  The State agency concurred with our findings and initiated corrective action.