Purpose

To determine the extent of implementation of the four recommendations included in our initial audit report, Collection of Medicaid Accounts Receivables (Report 2009-S-59).

Background

Our initial audit report, which was issued on September 9, 2010, examined whether the Department of Health (Department) effectively recovered accounts receivable when Medicaid overpaid providers. For the period January 1, 2006 through February 18, 2010, we found the Department needed to act more effectively to collect about $37 million of accounts receivable attributable to inactive providers, providers who join group practices and providers who are affiliated and share the same federal taxpayer identification number. We also found the Department needed to act more promptly to recover amounts repaid to the federal government for receivables that eventually became uncollectible and, therefore, were written off. We recommended the Department determine the feasibility of pursuing the collection of accounts receivable due from inactive providers and seek recovery of accounts receivable that were owed by providers when they joined a group practice. We also recommended the Department ensure its procedures and practices address the recovery of all accounts receivables identified through audits or retroactive rate adjustments for affiliated providers and that the Department acts in a timely manner to routinely refer appropriate accounts receivable to the State Attorney General for collection.

Key Finding

Department and Office of the Medicaid Inspector General officials have made progress in correcting the problems we identified in the initial report.  All four prior audit recommendations have been partially implemented.

Key Recommendation

Officials are given 30 days after the issuance of the follow-up review to provide information on any actions that are planned to address the unresolved issues discussed in this review.

Other Related Audit/Report of Interest

Department of Health: Collection of Medicaid Accounts Receivables (2009-S-59)