Office of Inspector General Partnership with the State of Ohio, Office of the Auditor's Report on Payments for Medicaid Services to Deceased Recipients

This audit was made by the Ohio Office of the Auditor and was conducted as part of the Inspector General's partnership efforts with States to expand audit coverage of the Medicaid program. The Office of the Auditor's final report points out that, during a period of almost 6 years, the Ohio Department of Human Services (ODHS) paid $82 million to providers claiming reimbursement for services to beneficiaries who were actually deceased at the time the services were supposedly performed. The ODHS is recovering the overpayments, but $14 million ($8.5 million Federal share) remained outstanding as of September 30, 1999. In addition to the financial adjustments and other procedural corrections, the Office of the Auditor recommended that ODHS propose legislation giving ODHS the authority to develop and apply sanctions against providers who do not report a beneficiary's death in a timely manner, or who bill for or retain unearned reimbursements, including reimbursements for services after a beneficiary's date of death. The ODHS generally agreed with the recommendations.