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

EXECUTIVE SUMMARY:

The objective of our review was to determine if the State agency reported Medicaid provider overpayments according to Federal regulations.  We found that the State agency did not report all Medicaid provider overpayments on the quarterly CMS 64 reports in accordance with Federal regulations.  The State's policies and procedures were not sufficient to ensure the timely reporting of all overpayments.  As a result, the State agency delayed returning 448 overpayments totaling $1,474,801 ($897,261 FFP).  Of that amount, the State agency had not yet reported or returned to the Federal Government 353 overpayments totaling $767,304 ($467,599 FFP) as of September 7, 2004.  We recommended that the State agency should:  (1) return the Federal share of overpayments totaling $467,599 to the Federal Government and (2) establish policies and procedures to ensure all overpayments are reported in accordance with Federal regulations.  The State agency generally agreed with our findings and recommendations.  It agreed to return $313,056, representing 345 overpayments, to the Federal Government and has initiated a repayment schedule for that amount.