Federal Reports

The New Jersey Department of Human Services (State agency) did not adequately oversee its Medicaid nonemergency medical transportation brokerage program to ensure that (1) vehicles used to transport beneficiaries met State standards, (2) drivers were licensed and qualified, (3) prior authorizations were obtained, (4) transportation providers maintained required insurance coverages, (5) beneficiaries received Medicaid-eligible medical services on the date of transportation, and (6) services were documented.

Christian Hospital (the Hospital) (operating in Saint Louis, Missouri) complied with Medicare billing requirements for 95 of the 199 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 104 claims, resulting in overpayments of $341,000 for calendar years 2012 and 2013. Specifically, 89 outpatient claims had billing errors, resulting in overpayments of almost $280,000, and 15 inpatient claims had billing errors, resulting in net overpayments of almost $62,000. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.

This grant provided the majority of the approved budget was for staff salaries, benefits and indirect costs.

This is a publication by GAO's Inspector General that concerns internal GAO operations. This report addresses the extent to which GAO has established an effective framework of controls to guide its contract management process.

Open World Leadership Center Financial Statement Audit - Auditor’s Report and Transmittal letter, July 2016