Wisconsin Improperly Claimed Federal Medicaid Reimbursement for Most Residential Care Center Payments.

摘要

Pursuant to Title XIX of the Social Security Act (the Act), the Medicaid program provides medical assistance to low-income individuals and individuals with disabilities. The Federal and State Governments jointly fund and administer the Medicaid program. The Centers for Medicare & Medicaid Services (CMS) administers the program at the Federal level. Each State administers its Medicaid program in accordance with a CMS-approved State plan. Although the State has considerable flexibility in designing and operating its Medicaid program, it must comply with applicable Federal requirements. States claim costs for Medicaid reimbursement on a quarterly basis using the Form CMS-64 (CMS-64). In Wisconsin, the Department of Health Services (State agency) administers the Medicaid program. Our objective was to determine whether the State agencys claims for Federal reimbursement for RCC HealthCheck costs complied with Federal requirements.