Florida 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 of last resort and should not pay for medical costs when there is another responsible entity (or program), including Medicare. The Office of Inspector 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. The objective of our audit was to determine whether the Florida Agency for Health Care Administration (State agency) overpaid Medicaid inpatient claims to hospitals that received Medicare payments for the same services.