Seven States' Medicaid Claims for 21- to 64-Year-Old Residents of Private and County-Operated Institutions for Mental Diseases

EXECUTIVE SUMMARY:

This report summarizes the results of our seven-State review of Medicaid claims for medical and ancillary services made on behalf of 21- to 64-year-old residents of private and county-operated institutions for mental disease (IMDs).  A common objective of these audits was to determine if controls were in place to preclude States from claiming Federal Medicaid funds for medical and ancillary services, including inpatient psychiatric services, provided to 21- to 64-year-old residents of private and county-operated IMDs.  Controls in several states reviewed were generally not adequate to prevent Federal Medicaid claims medical and ancillary services provided to 21- to 64-year-old residents of private and county-operated IMDs.  We found that the seven states improperly claimed a total of $6,149,988 in Federal Medicaid funds during various audit periods.  This summary report does not contain any recommendations.