Contingency Fees Claimed by Colorado as Medicaid Reimbursement

EXECUTIVE SUMMARY:

The objective of this review was this determine whether Colorado claimed consultant fees, related to identifying family planning costs for Medicaid managed care, in accordance with Federal laws and regulations.  >Colorado did not claim payments made to a consultant in accordance with Federal laws and regulations.  As a result, Colorado received $179,267 that does not qualify for Federal Medicaid reimbursement.  We recommended Colorado refund $179,267 to the Federal government, and  implement adequate controls to ensure all claims for Medicaid reimbursement involving payments made to consultants are submitted in accordance with Federal laws and regulations.  Colorado agreed with our findings and recommendations.