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The Minnesota State Medicaid Agency Made Capitation Payments to Managed Care Organizations After Beneficiaries' Deaths

Submitting OIG: 
Department of Health & Human Services OIG
Report Description: 
We estimated that Minnesota made unallowable capitation payments totaling at least $3.7 million ($3.2 million Federal share) to MCOs on behalf of deceased beneficiaries during our audit period. Of the 100 capitation payments in our random sample, Minnesota made 95 unallowable payments totaling $62,665 ($55,932 Federal share).
Date Issued: 
Tuesday, October 1, 2019
Agency Reviewed / Investigated: 
Department of Health & Human Services
Submitting OIG-Specific Report Number: 
A-05-17-00049
Component, if applicable: 
Centers for Medicare & Medicaid Services
External entity, if applicable: 
The Minnesota State Medicaid Agency
Location(s): 
MN
United States
Type of Report: 
Audit
View Document: 
AttachmentSize
PDF icon 51700049.pdf526.63 KB
Additional Details Link: 
https://oig.hhs.gov/oas/reports/region5/51700049.asp

Related Open Recommendations

Recommendation Number Recommendation Status Significant Recommendation Additional Details
267503 Open No
We recommend that the Minnesota Department of Human Services refund $3,243,531 to the Federal Government
267505 Open No
We recommend that the Minnesota Department of Human Services identify capitation payments made on behalf of deceased beneficiaries before and after our audit period and repay the Federal share of amounts recovered
267507 Open No
We recommend that the Minnesota Department of Human Services utilize additional sources to identify dates of death to help reduce unallowable payments
Displaying 3 of 3 Recommendations