Purpose

To determine the extent of implementation of the two recommendations made in our audit report, Inappropriate Medicaid Payments for Recipients with Multiple Identification Numbers and No Social Security Numbers (2010-S-29).

Background

Our initial audit report, which was issued on July 24, 2012, examined whether the Department of Health (Department) ensured local social service districts (local districts) properly assigned identification numbers to individuals eligible for Medicaid, and whether inappropriate Medicaid payments were made as a result of recipients being assigned multiple identification numbers. The Department oversees and establishes guidelines for local districts regarding Medicaid eligibility. Local districts are responsible for determining whether individuals applying for Medicaid meet eligibility requirements, and they are also responsible for assigning eligible Medicaid recipients unique identification numbers. The recipient identification number is a critical factor in determining the appropriateness of Medicaid payments.

For the three years ended May 31, 2010, our audit identified $17.3 million in Medicaid overpayments because 9,848 recipients were enrolled into Medicaid with multiple identification numbers. We recommended that the Department take steps to minimize the potential for the issuance of multiple identification numbers to the same recipient and investigate and recover the inappropriate payments we identified.

Key Finding

Officials have made progress in correcting the problems we identified in the initial audit report. This included the recovery of approximately $2.7 million in Medicaid overpayments for services provided to recipients with multiple identification numbers. Of the initial report's two recommendations, one was implemented and one was partially implemented.

Key Recommendation

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

Other Related Audit/Report of Interest

Department of Health: Inappropriate Medicaid Payments for Recipients With Multiple Identification Numbers and No Social Security Numbers (2010-S-29)