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Audit (A-07-10-03158)

Review of Medicaid Expenditures for Medicare Part A and Part B Premiums in Missouri

Executive Summary

The Missouri Department of Social Services (State agency) overclaimed $2.1 million ($1.5 million Federal share) in Medicaid expenditures for Medicare Part B premiums during fiscal year 2009. Specifically, the State agency made calculation errors when completing Form CMS-64, Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program (CMS-64 report). The CMS-64 report is an accounting statement that the State agency must submit to CMS within 30 days after the end of each quarter. The expenditures reported on the CMS-64 report and its attachments must represent actual expenditures for which all supporting documentation, in readily reviewable form, has been compiled and that is available at the time the claim is filed. In addition, the State agency must maintain an accounting system and supporting fiscal records to assure that claims reported on the CMS-64 report are in accordance with applicable Federal requirements. The State agency claimed the Medicaid expenditures for Medicare Part A premiums pursuant to Federal requirements

We recommended that the State agency (1) refund $1.5 million to the Federal Government for overclaimed Medicaid expenditures for Medicare Part B premiums and (2) strengthen internal controls to ensure that all Medicaid expenditures claimed for Federal reimbursement are in accordance with Federal requirements. The State agency agreed with our recommendations and described corrective actions that it had taken.

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