Twelve Selected States Did Not Accurately Calculate the Federal Share of Medicaid Collections Subject to the Increased COVID-19 Federal Medical Assistance Percentages

Date Issued

Monday, December 16, 2024

Submitting OIG

Department of Health & Human Services OIG

Agencies Reviewed/Investigated

Department of Health & Human Services

Report Number

A-06-23-09002

Report Type

Audit

Agency Wide

Yes

Number of Recommendations

Questioned Costs

$61,792,714

Funds for Better Use

Report updated under NDAA 5274

External Link

Open Recommendations

This report has 4 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
25-A-06-024.01	No	$61,792,714	$0
We recommend that the Centers for Medicare & Medicaid Services require the States to correct the reported Federal share of collections that were subject to the increased COVID-19 FMAP by recouping $62,504,429 from the 11 States that underreported the Federal share of Medicaid collections and refunding $711,715 to 1 State that overreported the Federal share of Medicaid
25-A-06-024.02	No	$0	$0
We recommend that the Centers for Medicare & Medicaid Services emphasize to States that they should consistently follow their procedures for calculating the Federal share of collections, including during periods of increased FMAPs.
25-A-06-024.03	No	$0	$0
We recommend that the Centers for Medicare & Medicaid Services reinforce with reviewers that they should verify that the increased Federal share for TPL collections was properly supported.
25-A-06-024.04	No	$0	$0
We recommend that the Centers for Medicare & Medicaid Services revise its policies and procedures for reviewing States' reported collections to include review of States' calculations of the Federal share for all collections.