Corporate Compliance

GOV’T AUDIT INSIDER: A need for strengthened policies and procedures in Wyoming

Healthcare Auditing Weekly, November 23, 2004

The Wyoming Department of Health incorrectly reported Medicaid provider overpayments for fiscal year 2003, and delayed returning the federal share of $211,667, according to an Office of Inspector General (OIG) audit report. Of that amount, Wyoming had not yet reported or returned $97,938 to the federal government as of February 12. The OIG recommends that Wyoming return the $97,983 to the federal government as soon as possible, strengthen its policies and procedures, report all overpayments as required, and coordinate all of the programs responsible for handling overpayments. During the audit, the OIG did the following:

  • Reviewed applicable federal and state criteria and regulations

  • Interviewed state agency officials and staff responsible for identifying, monitoring, and reporting overpayments

  • Reviewed documentation to determine date of discovery and status of overpayments

  • Compared CMS-64 reports submitted by Wyoming to supporting documentation

  • Utilized the Medicaid Statistical Information System to verify the collection of some overpayments

  • Reviewed the Negative Balance Detail Report prepared by an outside contractor

  • Calculated the number of days between the actual required reporting dates for identified overpayments

  • Calculated potential lost interest for overpayments that were reported late

    Click here to read the audit report, "Review of Wyoming's Accounts Receivable System for the period October 1, 2002, through September 30, 2003," (A-03-04-00205), issued October 13.

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