Corporate Compliance

GOV’T AUDIT INSIDER: Failure to report Medicaid provider overpayments in Alaska

Healthcare Auditing Weekly, November 30, 2004

Alaska's Department of Health and Social Services did not report more than $1.8 million in Medicaid provider overpayments and netted overpayments against expenditures from October 1, 2002, to September 30, 2003. According to an OIG audit report, the state's lack of adequate policies and procedures accounted for the failure, therefore depriving the federal government of its appropriate refund and preventing CMS from monitoring the total overpayment amounts. The OIG recommends that the state report the overpayments on the CMS-64, refund the federal share, and establish policies and procedures to ensure proper reporting. During the audit, the OIG did the following:

  • Reviewed applicable sections of the Social Security Act and the CMS state medicaid manual

  • Interviewed staff and reviewed applicable records

  • Analyzed the quarterly CMS-64 reports for the period October 1, 2002, through September 30, 2003, along with supporting documentation provided by the state

  • Determined whether overpayments were included in the state's accounting system and promptly reported on the CMS-64

    Click here to read the audit report, "Review of Alaska's Accounts Receivable System for Medicaid Provider Overpayments," (A-09-04-00047), issued October 20.

    • Strategies for Health Care Compliance
    • Strategies for Health Care Compliance

      News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...

    • Compliance Monitor

      This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...

    • Medicare Weekly Update

      Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...

    • Medicare Update for Physician Services

      Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...

    Most Popular

    Related Articles