Submitting OIG:
Report Description:
Pennsylvania did not ensure that its managed-care organizations complied with Federal and State requirements prohibiting Medicaid payments to providers for inpatient hospital services related to treating certain provider-preventable conditions. For our audit period, we identified that managed-care organizations paid providers approximately $43.5 million for 576 claims that contained provider-preventable conditions.
Date Issued:
Wednesday, August 7, 2019
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-03-16-00205
Component, if applicable:
Centers for Medicare & Medicaid Services
Location(s):
Agency-Wide
Type of Report:
Audit
Number of Recommendations:
8
View Document:
Attachment | Size |
---|---|
31600205.pdf | 604.13 KB |
Additional Details Link: