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Department of Health and Human Services

Office of Inspector General -- AUDIT

"California: Review of Short/Doyle Medicaid Contract Rates for Fiscal Years 1985 through 1989," (A-09-92-00094)

March 10, 1993


Complete Text of Report is available in PDF format (1.66 MB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.

EXECUTIVE SUMMARY:

Short/Doyle is one component of the California Medicaid program. It is a special program serving the mentally ill, and is operated by the various counties in California which arrange for hospital and clinic services. In Fiscal Year (FY) 1985, the State began negotiating Short/Doyle contracts with selected counties. Initially, three counties received contracts. By FY 1988, 14 counties operated under this arrangement. Our audit disclosed that excessive Medicaid payments were made to these counties. The payments exceeded Medicaid limits by about $15 million ($7.5 million Federal share) over 5 years. We recommended that the State refund the $7.5 million and establish procedures to ensure that payments are properly limited in the future. State officials did not agree with our finding and recommendations. However, regional Health Care Financing Administration officials concurred.