Audit of Medicaid Clinical Laboratory Services in Oklahoma for Calendar Years 1996 through 1999

This audit was conducted as a joint Federal/State project under the Office of Inspector General's Partnership Plan with the Oklahoma Health Care Authority (OHCA).  The review indicated that OHCA did not have adequate edits in its claim processing system to ensure that all reimbursement for clinical laboratory tests under Medicaid did not exceed amounts recognized by the Medicare program.  Based on the results of our review for laboratory procedures performed during the period January 1996 through December 1999, we determined that OHCA made payments of $54,780 ($38,690 Federal share) in excess of what Medicare recognizes for the same tests.  In addition to procedural corrections, the OHCA agreed to a financial adjustment for the $38,690.