Virginia Received Millions in Unallowable Bonus Payments

Some of the bonus payments that Virginia received for the audit period were not allowable in accordance with Federal requirements. Most of the data used in Virginia's bonus payment calculations were in accordance with Federal requirements. However, Virginia overstated its current enrollments in its bonus requests to the Centers for Medicare & Medicaid Services (CMS) for fiscal years (FYs) 2011 through 2013 because it improperly inflated its current enrollment by a fixed percentage estimate, to account for potential retroactive enrollment, instead of using actual enrollment and the adjustment process to account for actual retroactive enrollment. CMS guidance instructed Virginia to calculate current enrollment based on actual enrollment.