Review of the Calculation Methodology Utilized for Disproportionate Share Hospital Amounts Claimed Under the Missouri Medicaid Program

The objective of this review was to verify that disproportionate share hospital (DSH) amounts claimed by Missouri for State Fiscal Year ended June 30, 1999 were calculated in accordance with the approved Medicaid State plan.  The report pointed out that DSH costs claimed on behalf of State mental hospitals were overstated due to a clerical error. A simple calculation error occurred while compiling DSH costs resulting in a $1.3 million Federal financial participation (FFP) overstatement.  We recommended that the State return $1.3 million to the Federal Government; review other years for similar errors and return any overpayments; and implement controls to ensure such calculation errors do not occur in the future. The State concurred with our finding that there was a $ 1.3 million FFP overpayment but did not respond to the remaining recommendations.