Georgia Did Not Always Accurately Report and Refund the Federal Share of Medicaid Collections for Calendar Years 2008 Through 2011

For calendar years 2008 through 2011, the Georgia Department of Community Health (State agency) did not always accurately report Medicaid collections on its Quarterly Medicaid Statement of Expenditures for the Medical Assistance Program. Of about $396 million in total collections, the State agency accurately reported and refunded the Federal share on about $20 million; however, it did not accurately report or refund the Federal share on about $376 million. As a result, the State agency underreported $10.9 million (Federal share) of collections to be refunded to the Federal Government.

We recommended that the State agency (1) refund $10.9 million to the Federal Government and (2) develop and implement internal controls to ensure that it adequately supports specific-period Federal medical assistance percentages used to calculate the Federal share of collections refunded. The State agency concurred with our second recommendation and described corrective actions that it planned to take. However, it did not concur with our first recommendation and maintained that it had provided us with cost settlement documentation that warranted adjustment of the recommended refund amount.