Audit of Medicaid Payments for Skilled Professional Medical Personnel Reimbursed at Enhanced Rates - October 1, 2002 Through September 30, 2003, Michigan Department of Community Health

EXECUTIVE SUMMARY:

The objective of this review was to determine if Michigan properly claimed Federal Medicaid funding at the enhanced rate for skilled professional medical personnel.  We found that Michigan improperly claimed costs totaling $87,151 for Federal fiscal year 2003.  These costs were claimed because the State agency did not have procedures in place that ensured only qualified individuals were claimed as skilled professional medical personnel.  Enhanced rates were improperly claimed for an employee whose position did not require medical expertise, one clerical staff who did not work for skilled professional medical personnel staff, and three employees who did not possess the required professional training and experience.  We recommended that the State agency refund $87,151 for the Federal share of unallowable Medicaid costs associated with the five individuals improperly claimed at the enhanced rate and implement procedures to ensure that only qualified individuals are claimed as skilled professional medical personnel.  The State agency agreed with our recommendations.