Errors in Medicaid eligibility determinations made by local departments of social services within Virginia's Medicaid program may have resulted in improper payments ranging from $18 million to $263 million during the 2009 federal fiscal year, according to a report from the Joint Legislative Audit and Review Commission (pdf).
The JLARC stated in the report that a large number of individuals simply may not have been eligible, and additional investments are needed to reduce future errors through improved state oversight of local departments of social services, modernized IT and extra training of local caseworkers.
Other key findings of the JLARC's report of Virginia's Medicaid program include the following:
• Recipient and provider fraud cost the general fund about $6.1 million in FY 2009.
• Some collections of improper payments were not pursued because of inadequate internal controls.
• The most common error was the recipient's file lacked documentation to determine eligibility.
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The JLARC stated in the report that a large number of individuals simply may not have been eligible, and additional investments are needed to reduce future errors through improved state oversight of local departments of social services, modernized IT and extra training of local caseworkers.
Other key findings of the JLARC's report of Virginia's Medicaid program include the following:
• Recipient and provider fraud cost the general fund about $6.1 million in FY 2009.
• Some collections of improper payments were not pursued because of inadequate internal controls.
• The most common error was the recipient's file lacked documentation to determine eligibility.
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