Review of Clinical Laboratory Services Paid by the Georgia Department of Community Health During the Period of October 1, 1996 Through June 30, 1999

EXECUTIVE SUMMARY:

Our review, performed in conjunction with the Georgia Department of Audits, identified improper laboratory service payments of $1,762,835 (Federal share $1,072,639) by the Georgia Department of Community Health for the period October 1, 1996 through June 30, 1999.  The overpayments resulted from inadequate edits and audits in the claims processing system.  We recommended that the State adjust the HCFA-64 report for the Federal portion of the overpayments, initiate recovery from providers for the full overpayment amounts and correct the deficiencies in their claims processing system.