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Gov’t audit insider: Iowa has insufficient records for A/R

Healthcare Auditing Weekly, April 20, 2004

Iowa didn't do its homework for records related to accounts receivable (A/R) for overpayments to Medicaid accounts, according to an Office of Inspector General (OIG), released April 13. The audit revealed that the state lacked internal controls necessary to maintain sufficient A/R records. 

If Iowa can get nailed for documentation requirements, you can too. Read the following to learn more about the OIG's protocol for audits of documentation related to A/R.

The audit objective was to examine whether records for A/R accounted for the overpayments reported to the Centers for Medicare and Medicaid Services (CMS), and to determine whether Iowa had sufficient policies and procedures for collecting those payments.

To work toward its objective, the OIG performed the following tasks:

• Reviewed relevant federal documentation criteria
• Examined Iowa's provider case file documentation to determine date of discovery, dates of collection activity, and whether any adjustments or write-offs for A/R occurred during the audit period
• Analyzed the above data to confirm that overpayments were reported accurately, and that they were compliant with time requirements
• Compared OIG analyses to the overpayment balances Iowa reported to CMS to confirm accuracy of the reports
• Worked with Iowa officials who are responsible for overpayment collections to better understand Iowa's controls and to discuss the fieldwork completed for this case

Click here to view the audit report called "Audit of medicaid provider Aaccounts receivable overpayments in Iowa (A-07-04-01002)."

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