Utah Generally Operated Its Medicaid Estate Recovery Program in Accordance With Requirements and in a Cost Effective Manner, but Utah Did Not Have Formal Written Procedures

Date Issued

Tuesday, November 12, 2024

Submitting OIG

Department of Health & Human Services OIG

Agencies Reviewed/Investigated

Department of Health & Human Services

Report Number

A-07-23-03257

Report Type

Audit

Agency Wide

Yes

Number of Recommendations

Questioned Costs

Funds for Better Use

Report updated under NDAA 5274

External Link

Open Recommendations

This report has 3 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
25-A-07-012.01	No	$0	$0
We recommend that the Utah Department of Health and Human Services improve its estate recovery program by establishing formal written estate recovery policies and procedures, to include policies and procedures regarding documentation to support its performance of estate recovery procedures for deceased Medicaid enrollees.
25-A-07-012.02	No	$0	$0
We recommend that the Utah Department of Health and Human Services improve its estate recovery program by implementing formal procedures to periodically review open cases and establish a timeframe for doing so.
25-A-07-012.03	No	$0	$0
We recommend that the Utah Department of Health and Human Services improve its estate recovery program by verifying that system edits are functioning properly and improving those system edits as necessary, and by verifying that caseworkers perform and document all applicable estate recovery procedures (including determining the amount of Medicaid paid claims, determining whether the enrollee had a surviving spouse or child(ren), and performing asset research) for deceased Medicaid enrollees.