Report File
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-07-15-01159
Report Description
The Centers for Medicare & Medicaid Services (CMS) had policies and procedures to ensure that payments were not made for Medicare services rendered to unlawfully present beneficiaries in accordance with Federal requirements, but it did not always follow those policies and procedures. When CMS's data systems indicated that at the time a claim was processed the beneficiary was unlawfully present, CMS had policies and procedures to prevent payment for Medicare services, and CMS followed those procedures.
Report Type
Audit
Agency Wide
Yes
Number of Recommendations
2
Questioned Costs
$9,267,392
Funds for Better Use
$0
Additional Details
