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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
Components
Centers for Medicare and Medicaid Services
Report Number
A-03-22-00203
Report Type
Audit
Location

VA,
United States

Number of Recommendations
5
Questioned Costs
$37,551,985
Funds for Better Use
$0
External Entity
Virginia Department of Medical Assistance Services

Open Recommendations

This report has 5 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
23-A-03-090.04 No $0 $0

We recommend that the Virginia Medicaid Department of Medical Assistance Services continue to pursue development and implementation of an automated matching and eligibility update process.

23-A-03-090.02 No $21,849,401 $0

We recommend that the Virginia Medicaid Department of Medical Assistance Services identify and recover unallowable capitaiton payments, which we estimate to be at least $21,849,401, made to MCOs during our audit period on behalf of deceased enrollees.

23-A-03-090.05 No $0 $0

We recommend that the Virginia Medicaid Department of Medical Assistance Services implement additional supervisory review to ensure that State agency personnel completely and accurately update the State agency's eligibility system based on information provided by the Virginia Department of Health's Office of Vital Statistics.

23-A-03-090.03 No $0 $0

We recommend that the Virginia Medicaid Department of Medical Assistance Services identify and recover unallowable capitation payments made on behalf of deceased enrollees in 2018 and 2022 (the years before and after our audit period) and repay the Federal share of amounts recovered.

23-A-03-090.01 No $15,702,584 $0

We recommend that the Virginia Medicaid Department of Medical Assistance Services refund $15,702,584 to the Federal Government.

Department of Health & Human Services OIG

United States