Submitting OIG:
Report Description:
The North Carolina Division of Medical Assistance (State agency) claimed school-based Medicaid administrative costs that were not in accordance with Federal requirements. The State agency used statistically invalid random moment sampling (RMS) in allocating costs to Medicaid, and it did not maintain adequate support to validate its sample results and related extrapolations. In addition, it claimed these costs without promptly submitting to the U.S. Department of Health and Human Services, Division of Cost Allocation (DCA), for review its cost allocation plan (CAP) amendment describing its new random moment timestudy (RMTS) methodology. Instead, the State agency claimed costs based on an implementation plan describing the new RMTS methodology, which was conditionally approved by CMS. As a result, the almost $107.5 million (almost $53.8 million Federal financial participation) the State agency claimed in school-based Medicaid administrative costs for Federal fiscal years 2010 through 2012 was unallowable.
Date Issued:
Thursday, October 6, 2016
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-04-15-00101
Component, if applicable:
Centers for Medicare & Medicaid Services
Location(s):
NC
United StatesType of Report:
Audit
Questioned Costs:
$53,719,199
Funds for Better Use:
$0
Number of Recommendations:
6
View Document:
Attachment | Size |
---|---|
41500101.pdf | 3.2 MB |
Additional Details Link: