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Medicaid Overpayment Reporting and Collections

Prior OIG audits identified Medicaid overpayments in various States and included recommendations for the collection of those overpayments. If a Federal audit indicates that a State has failed to identify an overpayment, Centers for Medicare & Medicaid Services considers the overpayment as discovered on the date that the Federal official first notifies the State in writing of the overpayment and specifies a dollar amount subject to recovery (42 CFR § 433.316(e)). Federal regulations require that States report overpayments to Centers for Medicare & Medicaid Services. For OIG audits in which Centers for Medicare & Medicaid Services concurred with recommendations to collect overpayments, we will determine whether the overpayments have been recouped and properly reported to Centers for Medicare & Medicaid Services.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Nov-16 Centers for Medicare & Medicaid Services Medicaid Overpayment Reporting and Collections Office of Audit Services W-00-17-31399; A-05-17-00000 2018

Office of Inspector General, U.S. Department of Health and Human Services | 330 Independence Avenue, SW, Washington, DC 20201