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Alabama Claimed Federal Medicaid Reimbursement for Millions of Dollars in Targeted Case Management Services That Did Not Comply With Federal and State Requirements

Submitting OIG: 
Department of Health & Human Services OIG
Date Issued: 
Tuesday, April 23, 2024
Agency Reviewed / Investigated: 
Department of Health & Human Services
Submitting OIG-Specific Report Number: 
A-07-22-03253
Component, if applicable: 
Centers for Medicare & Medicaid Services
Location(s): 
AL
United States
Type of Report: 
Audit
Questioned Costs: 
$5,039,433
Funds for Better Use: 
$0
Number of Recommendations: 
2
Report updated under NDAA 5274: 
No
View Document: 
AttachmentSize
PDF icon Alabama-Claimed-Fed-Medicaid.pdf1.49 MB
Additional Details Link: 
https://oig.hhs.gov/reports-and-publications/all-reports-and-publications/alabam…

Related Open Recommendations

Recommendation Number Recommendation Status Significant Recommendation Additional Details
24-A-07-060.01 Open No
We recommend that the Alabama Medicaid Agency refund to the Federal government $5,039,433 (Federal Share) in overpayments.
24-A-07-060.02 Open No
We recommend that the Alabama Medicaid Agency improve TCM program oversight by giving additional guidance to TCM providers regarding: billing of services, to verify that they are allowable and nonduplicative; case manager hiring practices, to verify adherence with the State plan's qualification requirements; target group eligibility screening processes, so that only eligible individuals receive TCM services; and the maintenance of supporting documentation for billed services.
Displaying 2 of 2 Recommendations