Review of Medicaid Excluded Providers in Missouri

The Missouri Department of Social Services, Missouri HealthNet Division (State agency), did not have adequate internal controls to prevent some Medicaid payments for items and services furnished, ordered, or prescribed by an excluded individual or entity. As a result, the State agency made $22,000 ($15,000 Federal share) in improper payments for the period January 1, 2007, through December 31, 2009.

We recommended that the State agency refund $15,000 to the Federal Government for the improper Medicaid payments and strengthen internal controls to prevent excluded providers from participating in the Medicaid program. The State agency partially concurred with both of our recommendations and described corrective actions that it planned to take.