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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
Department of Housing and Urban Development
Health Concepts Ltd’s., Providence, RI Service Charges at FHA-Insured Nursing Homes Did Not Always Comply With Management Agreements
This is a publication by GAO's Inspector General that concerns internal GAO operations. This report was submitted to the Comptroller General in accordance with Section 5 of the Government Accountability Office Act of 2008. The report summarizes the activities of the Office of Inspector General (OIG) for the first reporting period of fiscal year 2017.
The Florida Agency for Health Care Administration (State agency) did not always suspend Medicaid payments to providers that had credible fraud allegation cases in accordance with the Social Security Act. Of the 95 cases that we reviewed, the State agency applied a good-cause exception not to suspend payments for 1 case; and it either suspended, pursued recovery, or otherwise did not make Medicaid payments to providers related to 40 other cases.
California Incorrectly Claimed Additional Medicaid Funding Authorized Under the Recovery Act When Reclaiming Overpayments Made to Bankrupt or Out-of-Business Providers
For Federal fiscal years 2010 through 2013, the California Department of Health Care Services (State agency) claimed $58.3 million in Federal reimbursement for Medicaid overpayments that it made to providers who were determined to be bankrupt or out of business (uncollectible overpayments). The State agency complied with Federal requirements when reclaiming Federal Medicaid reimbursement for uncollectible overpayments. However, the State agency incorrectly used increased Federal medical assistance percentages (FMAPs) authorized under the American Recovery and Reinvestment Act to claim additional Federal reimbursement of $6.6 million for uncollectible overpayments that were not originally made during the recession adjustment period (October 1, 2008, through June 30, 2011) or were not previously refunded to the Federal Government using the increased FMAPs.
