Audit Agency
Department of Health and Human Services Office of Inspector General
3 indexed reports
US
2025
Illinois Medicaid Managed Care Capitation Payments for Incarcerated Enrollees
U.S. Department of Health and Human Services Office of Inspector General
Published 2025
The audit determined that Illinois made unallowable managed care capitation payments for incarcerated enrollees during the audit period, totaling at least $9.5 million with $8.3 million Federal share,...
US
2024
California Payments for Enrollees With Concurrent Medicaid Enrollment in Another State
Department of Health and Human Services Office of Inspector General
Published 2024
We estimated that the State agency incurred costs of approximately $19.9 million ($15.5 million Federal share) for August 2021 capitation payments made on behalf of enrollees who were residing and con...
RI
2024
Medicaid Capitation Paid for Members Residing in Other States
Rhode Island Office of the Auditor General (RIOAG) in collaboration with the U.S. Department of Health and Human Services Office of Inspector General (OIG)
Published 2024
Rhode Island Medicaid paid approximately $38.4 million in capitation payments to MCOs for members who were not residing in Rhode Island, indicating noncompliance with state and federal residency requi...