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Florida Made Capitation Payments for Enrollees Who Were Concurrently Enrolled in a Medicaid Managed Care Program in Another State

Submitting OIG: 
Department of Health & Human Services OIG
Date Issued: 
Thursday, February 16, 2023
Agency Reviewed / Investigated: 
Department of Health & Human Services
Submitting OIG-Specific Report Number: 
A-05-21-00028
Component, if applicable: 
Centers for Medicare & Medicaid Services
Centers for Medicare and Medicaid Services
External entity, if applicable: 
Florida Agency for Health Care Administration
Location(s): 
US
FL
Type of Report: 
Audit
Questioned Costs: 
$0
Funds for Better Use: 
$0
Number of Recommendations: 
3
View Document: 
AttachmentSize
PDF icon 52100030.pdf1.94 MB

Related Open Recommendations

Recommendation Number Recommendation Status Significant Recommendation Additional Details
23-A-05-042.01 Open No
We recommend that the Florida Agency for Health Care Administration resume and enhance procedures that are in accordance with Federal requirements and the State's unwinding plan to identify and disenroll enrollees who are residing and enrolled in Medicaid managed care in another State when the PHE ends.
23-A-05-042.02 Open No
We recommend that the Florida Agency for Health Care Administration work with CMS to consider the potential use of T-MSIS data to identify potential cases of concurrent enrollment.
Displaying 2 of 2 Recommendations