Audit of Vermont's Medicaid Payments for Family Planning Services Reimbursed at Enhanced Rates for the Period October 1, 2003 Through September 30, 2004

EXECUTIVE SUMMARY:

Our objective was to determine if the Vermont Agency of Human Services, Office of Vermont Health Access (the State agency) properly claimed Federal financial participation for claims related to family planning services in accordance with applicable Federal regulations and the Medicaid State Plan. From October 2003 through September 2004, the State agency improperly claimed a total of $323,367 for Federal Medicaid reimbursement for family planning services.  The State agency claimed these costs because it did not reconcile the quarterly claims for enhanced reimbursement with paid claim activity for such services and because it did not have adequate procedures in place to ensure that only eligible family planning services were claimed for enhanced Federal funding.  We recommended that the State refund $323,367 for the Federal share of unallowable Medicaid costs and implement procedures to ensure that future claims are eligible for the enhanced Federal funding rate.  State officials agreed with our recommendations.

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