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Series: Audits of Medicaid Collections During COVID-19 Federal Medical Assistance Percentage Increase

Announced on  | Last Modified on  | Series Number: W-00-24-31569
Status
Active
Agency
Centers for Medicare and Medicaid Services

OBJECTIVE

The Federal Government pays its share of a State's Medicaid expenditures based on the Federal Medical Assistance Percentage (FMAP), which varies depending on a State's relative per capita income. In response to the pandemic, the Families First Coronavirus Response Act provided a temporary 6.2-percentage-point increase to each qualifying State's and Territory's FMAP effective January 1, 2020. States must refund the Federal share of overpayments and other collections, which decreases the amount of Federal funding States receive for a quarter. CMS instructs States to make refunds of the Federal share at the FMAP at which the original expenditures were reimbursed. We will audit selected States to determine whether those States used the correct FMAP when making refunds of the Federal share.

There are 2 projects in this series.

Project titles will remain unpublished until projects are complete and reports are posted.

ACTIVE PROJECTS IN THIS SERIES (1)

Project OAS-25-04-114 • Announced on May 29, 2025

COMPLETED PROJECTS IN THIS SERIES (1)

Review of States' Use of the COVID 19 FMAP to Calculate the Federal share of Collections

Project A-06-23-09002 • Completed on December 16, 2024

TIMELINE

  • January 9, 2023
    Series Number W-00-24-31569 Assigned
  • January 9, 2023
    Project Announced

    Review of States' Use of the COVID 19 FMAP to Calculate the Federal share of Collections - A-06-23-09002

  • December 16, 2024
    Project Complete - A-06-23-09002

    Review of States' Use of the COVID 19 FMAP to Calculate the Federal share of Collections has been marked as complete. This audit resulted in 4 recommendations.

  • May 29, 2025
    Project Announced

    Project OAS-25-04-114

  • Today
    1 Audit In-Progress
  • Est FY2026
    Estimated Fiscal Year for Series Completion

1 REPORT PUBLISHED

Twelve Selected States Did Not Accurately Calculate the Federal Share of Medicaid Collections Subject to the Increased COVID-19 Federal Medical Assistance Percentages (A-06-23-09002)

25-A-06-024.01 to CMS - Open Unimplemented
Update expected on 02/25/2026
We recommend that the Centers for Medicare & Medicaid Services require the States to correct the reported Federal share of collections that were subject to the increased COVID-19 FMAP by recouping $62,504,429 from the 11 States that underreported the Federal share of Medicaid collections and refunding $711,715 to 1 State that overreported the Federal share of Medicaid collections.

25-A-06-024.02 to CMS - Open Unimplemented
Update expected on 02/25/2026
We recommend that the Centers for Medicare & Medicaid Services emphasize to States that they should consistently follow their procedures for calculating the Federal share of collections, including during periods of increased FMAPs.

25-A-06-024.03 to CMS - Closed Implemented
Closed on 08/25/2025
We recommend that the Centers for Medicare & Medicaid Services reinforce with reviewers that they should verify that the increased Federal share for TPL collections was properly supported.

25-A-06-024.04 to CMS - Open Unimplemented
Update expected on 02/25/2026
We recommend that the Centers for Medicare & Medicaid Services revise its policies and procedures for reviewing States' reported collections to include review of States' calculations of the Federal share for all collections.

View in Recommendation Tracker
Work Plan Type
Office of Audit Services
HHS Agencies
Centers for Medicare and Medicaid Services
Issue Areas
COVID-19
Target Groups
-
Financial Groups
Medicaid