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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-05-16-00061
Report Description

Ohio makes capitation payments to five managed care organizations (MCOs) for beneficiaries in the Medicaid Managed Care (MMC) program. Previous OIG reviews in other States identified Medicaid payments made on behalf of ineligible beneficiaries and duplicative monthly capitation payments.

Report Type
Audit
Location

OH
United States

Additional Details
https://oig.hhs.gov/oas/reports/region5/51600061.asp

Open Recommendations

This report has 2 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
267405 No $0 $0

We recommend that the Ohio Department of Medicaid implement system prompts in Ohio Benefits that encourage users to verify the beneficiary’s date of birth or gender before making changes in the system

267402 No $6,729,855 $0

We recommend that the Ohio Department of Medicaid refund $6,729,855 (Federal share) in overpayments to the Federal Government

Department of Health & Human Services OIG

United States