Public audit ledger

Medicaid audit reports

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Evidence register

174 reports

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Published: Jan 19, 2019
Jurisdiction: Texas

Publishing agency: Texas State Auditor's Office
Report ID: REPORT 26

Medicaid Managed Care Contract Processes at the Health and Human Services Commission

The Commission has made significant progress in establishing processes and controls for Medicaid managed care contract management, aligning with Senate Bill 894 requirements. However, further efforts are needed to fully implement planned audits, monitoring activities, and IT c…

Findings: 4
Recommendations: 6

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Source status: Original source

Published: Dec 2018
Jurisdiction: Missouri

Publishing agency: Missouri State Auditor
Report ID: REPORT 80

Department of Social Services Prescription Drug Oversight

The audit found that while cost containment measures have contributed to reductions in prescription drug payments after 2015, significant control gaps remain, notably the absence of a comprehensive statewide PDMP and incomplete collection of National Drug Codes for physician-a…

Findings: 4
Recommendations: 0

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Source status: Original source

Published: Jul 26, 2018
Jurisdiction: Federal

Publishing agency: U.S. Government Accountability Office
Report ID: REPORT 28

Medicaid Managed Care Improvements Needed to Better Oversee Payment Risks

The GAO found that Medicaid managed care faces significant payment risks and oversight challenges. CMS's efforts to improve program integrity have been delayed and insufficient, risking continued payment errors and fraud. Strengthening oversight and guidance is essential to mi…

Findings: 3
Recommendations: 3

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Source status: Original source

Published: Jan 1, 2018
Jurisdiction: Illinois

Publishing agency: Illinois Office of the Auditor General
Report ID: REPORT 23

Performance Audit of Medicaid Managed Care Organizations for Fiscal Year 2016

HFS failed to maintain complete and accurate data to monitor payments to and from MCOs, leading to potential overpayments, duplicate payments, and lack of oversight on costs and claims processing.

Findings: 10
Recommendations: 6

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Source status: Original source

Published: Feb 15, 2008
Jurisdiction: Ohio

Publishing agency: Ohio Auditor of State
Report ID: REPORT 24

Audit of Medicaid Reimbursements Made to Regency Manor Rehabilitation

The audit identified overpayments totaling $58,540.97 due to billing inaccuracies in room and board, and therapy services. The provider is responsible for repayment, and the Department of Job and Family Services will make final determinations regarding recovery.

Findings: 3
Recommendations: 2

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Source status: Original source

Published: Jun 29, 2000
Jurisdiction: Ohio

Publishing agency: Ohio Auditor of State
Report ID: REPORT 19

Review of Medicaid Provider Reimbursements made to Crest Transportation Service

The review identified significant non-compliance with Medicaid reimbursement rules by Crest Transportation Service, resulting in overpayments and raising concerns about potential fraud and abuse. The provider’s documentation deficiencies, billing irregularities, and the owner’…

Findings: 8
Recommendations: 4

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Source status: Original source