Corporate Compliance

GOV’T AUDIT INSIDER: Iowa’s rehab services need stronger internal controls

Healthcare Auditing Weekly, August 3, 2004

Nearly one-third of the amounts claimed by the state of Iowa for its Rehabilitative Treatment Services Family-Centered Program did not meet Medicaid reimbursement requirements in the federal fiscal year (FFY) 2001, according to an OIG audit report.  The OIG determined that a lack of adequate internal controls over the Family-Centered Program caused $2,536,187 in state claims to not meet the required criteria for Medicaid reimbursement.  The OIG recommended that the state refund the federal government and strengthen its policies and procedures.  During the audit, the OIG did the following:

  • Selected a simple random sample of 100 claims from a population of 45,895 claims for FFY 2001

  • Reviewed state and federal laws, regulations, and guidelines

  • Held discussions with the CMS regional office personnel, state officials, and contractors who were responsible for the authorization of services, certification of providers, and transmission of data

    Click here to read the audit report "Audit of Medicaid Claims for Iowa Rehabilitation Treatment Services Family-Centered Program," (A-07-02-03023), released July 6.

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