South Carolina Paid Hospitals for Some Inpatient Hospital Services That Medicare Paid.

摘要

Medicaid provides health coverage to 8.3 million 'dually eligible' low-income seniors and people with disabilities, who are enrolled in both Medicaid and Medicare. However, Medicaid is the payer oflast resort and should not pay for medical costs when there is another responsible entity (or program), including Medicare. The Office oflnspector General has consistently identified Medicaid overpayment issues. In this audit, we focused on Medicaid overpayments when Medicare and Medicaid both pay for the same services. We are conducting this audit in multiple States. Our objective was to determine whether the South Carolina Department of Health and Human Services (State agency) overpaid Medicaid inpatient claims to hospitals that received Medicare payments for the same services.