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Where To Report Waste Fraud, Abuse, Or Retaliation

Texas Did Not Make Increased Primary Care Provider Payments and Claim Reimbursement in Accordance With Federal Requirements

Submitting OIG: 
Department of Health & Human Services OIG
Report Description: 
Texas did not always make increased Medicaid payments to providers and claim reimbursement in accordance with Federal requirements. Of the $721 million in Federal funds that it received, Texas inappropriately received $20.7 million because (1) it incorrectly claimed the 100-percent matching rate for payments that were only eligible for the regular matching rate and (2) it made payments that were unallowable.
Date Issued: 
Friday, April 13, 2018
Agency Reviewed / Investigated: 
Department of Health & Human Services
Submitting OIG-Specific Report Number: 
A-06-15-00045
Component, if applicable: 
Centers for Medicare & Medicaid Services
Location(s): 
TX
United States
Type of Report: 
Audit
Questioned Costs: 
$20,714,957
Number of Recommendations: 
2
View Document: 
AttachmentSize
PDF icon 61500045.pdf1.02 MB
Additional Details Link: 
https://oig.hhs.gov/oas/reports/region6/61500045.asp

Related Open Recommendations

Recommendation Number Recommendation Status Significant Recommendation Additional Details
263507 Open No
We recommend that Texas refund $20.7 million to the Federal Government that it received for incorrectly claimed and unallowable payments.
263508 Open No
We recommend that Texas work with the Centers for Medicare & Medicaid Services to determine the portion of the $1.1 million that it received for payments that exceeded providers’ billed charges should be refunded to the Federal Government.
Displaying 2 of 2 Recommendations