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Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-07-19-02822
Report Description

In 2010, Congress passed the Patient Protection and Affordable Care Act (ACA). The ACA established enhanced Federal reimbursement rates for services provided to nondisabled, low-income adults without dependent children (new adult group). The enhanced reimbursement rates established under the ACA have raised concerns about the possibility that States could improperly enroll individuals for Medicaid coverage in the new adult group and, as a consequence, the potential for improper payments.Our objective was to determine whether Colorado complied with Federal and State requirements when claiming Federal Medicaid reimbursement for Medicaid services provided to beneficiar

Report Type
Audit
Location

CO,
United States

Number of Recommendations
3
Questioned Costs
$0
Funds for Better Use
$0

Open Recommendations

This report has 3 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
269323 No $0 $0

update the CBMS by implementing an automatically accessible eligibility history that retains all beneficiary histories when retroactive changes occur, thereby eliminating the need for manual interventions to identify changes in eligibility status

269324 No $0 $0

ensure that the MMIS retains all beneficiary eligibility changes and reconcile the beneficiaries’ data contained in the MMIS to the data in the CBMS to determine whether discrepancies in Medicaid eligibility groups are occurring

269325 No $0 $0

ensure that the CBMS has automated edits to enroll Transitional Medicaid beneficiaries in the correct eligibility group

Department of Health & Human Services OIG

United States