Review of Medicaid Credit Balances at Baystate Franklin Medical Center for the Period Ending June 30, 2006

EXECUTIVE SUMMARY:

Our objective was to determine whether the credit balances recorded in Baystate Franklin Medical Center's (the Hospital) accounting records for inpatient and outpatient services for Medicaid beneficiaries represented overpayments more than 60 days old that the Hospital should have returned to the Medicaid program. We identified 306 overpayments more than 60 days old that the Hospital should have returned to the Medicaid program. As a result, the Hospital did not promptly return Medicaid overpayments totaling $80,272 ($40,136 Federal share) to the Medicaid program in accordance with State Medicaid requirements. We recommended that the Hospital return to the Massachusetts Medicaid program overpayments totaling $80,272 ($40,136 Federal share) and continue efforts to identify and return all overpayments to Medicaid in accordance with State requirements. The Hospital agreed substantially with our observations and findings.