Audit Agency
Office of Inspector General, U.S. Department of Health and Human Services
3 indexed reports
US
2025
Medicaid Agencies Made Millions in Unallowable Capitation Payments to Managed Care Organizations on Behalf of Deceased Enrollees
Office of Inspector General, U.S. Department of Health and Human Services
Published 2025
We estimate that Medicaid agencies made $207,501,380 ($138,645,710 Federal share) in unallowable capitation payments to MCOs for deceased enrollees during the audit period (July 1, 2021 – June 30, 202...
US
2025
Colorado Made Capitation Payments to Managed Care Organizations After Enrollees’ Deaths
Office of Inspector General, U.S. Department of Health and Human Services
Published 2025
The audit found that Colorado made unallowable capitation payments to Medicaid managed care organizations for deceased enrollees, resulting in significant financial losses and reporting inaccuracies. ...
US
2022
The Centers for Medicare & Medicaid Services’ Review Contractors Generally Conducted Medicaid Fee-for-Service Claim Reviews for Selected States Under the Payment Error Rate Measurement Program in Accordance with Federal and State Requirements
Office of Inspector General, U.S. Department of Health and Human Services
Published 2022
CMS’s review contractors adequately conducted Medicaid FFS claim reviews for three States (Arkansas, Connecticut, and New Mexico) under the PERM program in accordance with Federal and State requiremen...