Accession Number PB2012-110917
Title Illinois Did Not Report All Medicaid Overpayments in Accord with Federal Requirements.
Publication Date Apr 2012
Media Count 15p
Personal Author N/A
Abstract Pursuant to Title XIX of the Social Security Act (the Act), the Medicaid program provides medical assistance to certain low-income individuals and individuals with disabilities. The Federal and State Governments jointly fund and administer the Medicaid program. At the Federal level, the Centers for Medicare & Medicaid Services (CMS) administers the program. Each State administers its Medicaid program in accordance with a CMS-approved State plan. Although the State has considerable flexibility in designing and operating its Medicaid program, it must comply with applicable Federal requirements. In Illinois, the Department of Healthcare and Family Services (State agency) administers the Medicaid program. The State agency, through the Illinois Department of Healthcare and Family Services, Office of Inspector General (HFS-OIG), conducts audits of Medicaid providers. In addition, HFS-OIG contracts annually with third parties to conduct audits of Medicaid providers. When State Medicaid audits identify overpayments, HFS-OIG sends letters to the providers identifying the overpayment amounts and providing information on arranging payments, sending additional documentation, or appealing the decision.
Keywords Audits
Claims
Disabled persons
Health insurance
Illinois
Low income groups
Medicare
Overpayments
Reimbursement
State agencies


 
Source Agency Department of Health and Human Services, Washington, DC
NTIS Subject Category 43A - Finance
44Q - Health Related Costs
70B - Management Practice
Corporate Author Department of Health and Human Services, Washington, DC. Office of the Inspector General.
Document Type Technical report
Title Note N/A
NTIS Issue Number 1219
Contract Number N/A

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