False claims for Medicaid reimbursement found in Missouri
Healthcare Auditing Weekly, October 2, 2007
The OIG found that Missouri's State agency claims for Medicaid reimbursement of graduate medical education (GME) payments made to Children's Mercy Hospital did not comply with federal law or the state plan. Specifically, the OIG found that Missouri was not entitled to claim reimbursement for certain public expenditures as the state share of DME costs.
Missouri's State agency was not entitled because the hospital did not certify the funds for all years audited, and Kansas City did not certify the funds before the State Agency claimed federal reimbursement.
The OIG recommended that the state agency
- Pay the federal government over $1 million in GME overpayments to the hospital
- Follow federal requirements and the state plan when making claims in the future
- Review claims for GME following the audit period and refund portions that were not within compliance
The State agency agreed with the last two recommendations, but disagreed with the first.
To read this report, click here.
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