Corporate Compliance

GOV’T AUDIT INSIDER: Kansas agency failed to report all Medicaid overpayments

Healthcare Auditing Weekly, February 1, 2005

The Kansas Department of Social and Rehabilitation Services did not report all Medicaid provider overpayments from October 1, 2002 to September 30, 2003, according to an OIG audit report. The agency delayed returning more than $2.3 million in overpayments, and still had not reported or returned the federal government's share of $537,210. The OIG recommends that Kansas return the federal share and strengthen policies and procedures to ensure all overpayments are in accordance with federal regulations.

During the audit the OIG did the following:

  • Reviewed applicable federal criteria and sections of the state Medicaid manual

  • Interviewed state and federal officials, as well as staff responsible for monitoring collection and reporting of overpayments

  • Reviewed overpayment case files

  • Reviewed information provided by the Medicaid Fraud Control Unit (MFCU) to determine outstanding balances for MFCU overpayments

  • Compared the CMS 64 reports to supporting documentation

  • Verified the collection of some overpayments with information provided by the Medicaid Management Information System

  • Calculated and analyzed the number of days between the actual and required reporting dates

  • Applied a cutoff date for the overpayments that remained unreported during the audit

    Click here to read the audit report, "Review of Kansas's Accounts Receivable System for Mediciad Provider Overpayments," (A-07-04-03060) issued January 12.

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