Federal Reports

A former AmeriCorps member submitted fraudulent claims for childcare benefits after ending her service. The United States Attorney’s Office declined criminal prosecution, and CNCS recouped $1,047 from the former member.

Precision Health, Inc., (Precision), (located in Staten Island, New York) complied with certain Medicare Part B requirements for 88 of the 117 claims that we sampled. However, the remaining 29 claims did not comply with certain Medicare requirements. On the basis of our sample results, we estimated that Precision improperly claimed at least $332,000 in Medicare reimbursement for unallowable portable x-ray services

The payments that Medicare contractors made to providers in Jurisdiction E (American Samoa, California, Guam, Hawaii, Nevada, and Northern Mariana Islands) and Jurisdiction F (Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, and Wyoming) for hospital outpatient dental services generally did not comply with Medicare requirements. Of the 100 dental services in our stratified random sample, 79 did not comply with Medicare requirements. Using our sample results, we estimated that Medicare contractors improperly paid providers in Jurisdictions E and F at least $818,000 from January 1, 2013, through December 31, 2014.

From October 1, 2009, through September 30, 2012, the Washington State Health Care Authority (State agency) claimed $117,000 in unallowable Federal Medicaid reimbursement for dental services. The unallowable payments consisted of (1) duplicate payments, (2) payments for services that were provided more frequently than State regulations allowed, and (3) payments for certain services that required prior authorization but for which the State agency did not have a record of providing authorization.