Review of Alaska's Accounts Receivable System for Medicaid Provider Overpayments

EXECUTIVE SUMMARY:

The objectives of this review were to determine if the State reported Medicaid provider overpayments according to Federal regulations and adequately performed and documented procedures to support credit adjustments.  We found that during the period October 1, 2002 through September 30, 2003, the State did not report Medicaid provider overpayments according to Federal regulations.  Specifically, the State did not report $1,874,978 in overpayments and netted other overpayments against expenditures.  The State did not properly report overpayments because it did not have adequate policies and procedures.  As a result, the State did not refund the Federal share of $1,092,663, and Centers for Medicare and Medicaid Services (CMS) is unable to monitor the total amount of overpayments each year.  We recommended that the State:  (1) report the $1,874,978 in overpayments on the CMS-64, thereby crediting the Federal share of $1,092,663 and (2) establish policies and procedures to ensure that all overpayments are reported according to Federal regulations.  The State agency concurred with our findings and initiated corrective action.