Corporate Compliance

GOV’T AUDIT INSIDER: Unallowable contingency fee payments in Virginia

Healthcare Auditing Weekly, December 14, 2004

Between October 2001 and April 2003, Virginia claimed $677,964 in unallowable contingency fee payments made to a consulting firm for providing federal revenue maximization services, according to an OIG audit report. The consulting firm increased federal revenues for Virginia by identifying expenditures eligible for 90% federal financial participation. The OIG recommends that Virginia refund the $338,982 federal share of improperly claimed fees. During the audit, the OIG did the following:

  • Reviewed all relevant criteria, regulations, policies, and contracts

  • Asked Virginia to self-disclose its contingency fee payments and claims with respect to family planning services

  • Reviewed form CMS-64

    Click here to read the audit report, "Review of Virginia's Contingency Fee Payments for Maximizing Federal Revenues Claimed by Its Medicaid Managed Care Program," (A-03-04-002 13) issued November 9.

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