CMS Is Not Systematically Tracking Whether States Return Federal Shares of Medicaid Managed Care Remittances

Date Issued

Tuesday, May 13, 2025

Submitting OIG

Department of Health & Human Services OIG

Agencies Reviewed/Investigated

Department of Health & Human Services

Report Number

OEI-03-23-00041

Report Type

Inspection / Evaluation

Agency Wide

Yes

Number of Recommendations

Questioned Costs

Funds for Better Use

Report updated under NDAA 5274

Open Recommendations

This report has 5 open recommendations.

Recommendation Number	Significant Recommendation	Recommended Questioned Costs	Recommended Funds for Better Use
25-E-03-027.01	No	$0	$85,117,345
CMS should obtain the Federal shares of MLR remittances from States that failed to return these amounts to CMS for the 2017-2018 and 2018-2019 MLR reporting years.
25-E-03-027.02	No	$0	$0
CMS should develop the capacity to systematically track and readily determine the amounts of the Federal shares of MLR remittances that States return to CMS.
25-E-03-027.03	No	$0	$0
CMS should improve internal communication to confirm that States return the Federal shares of the MLR remittance amounts reported annually to CMS.
25-E-03-027.04	No	$0	$0
CMS should routinely confirm that States return the Federal shares of State-reported MLR remittance amounts.
25-E-03-027.05	No	$0	$0
CMS should develop procedures to track (a) when each State is expected to return the required Federal shares of MLR remittances owed and (b) whether States have returned the Federal shares timely.