Author: U.s. Government Accountability Office

Publisher: Createspace Independent Publishing Platform

Published: 2017-08-05

Total Pages: 26

ISBN-13: 9781974265923

" While states and certain federal entities have had long-standing roles identifying Medicaid improper payments, the Deficit Reduction Act of 2005 expanded CMS's role in identifying improper payments. As a result, CMS created a national audit program, which uses federal contractors to audit state Medicaid claims and identify overpayments-payments that should not have been made or were higher than allowed-to providers. States are responsible for recovering any identified overpayments and reporting the return of the federal share of those overpayments to CMS. GAO was asked to examine states' efforts to recover and report overpayments identified by federal audits, and examine CMS's review of state reporting. This report assesses the extent to which: (1) states recovered Medicaid overpayments identified by federal audits and reported the return of the federal share, and (2) CMS reviewed states' reporting of Medicaid overpayments related to these federal audits. GAO obtained overpayment and recovery data from all states with an identified overpayment and compared this with CMS data; reviewed relevant laws, regulations, and CMS guidance; and interviewed CMS and state officials. "