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Audit (A-01-08-00003)

09-08-2009
Review of Connecticut’s Community Based Medicaid Administrative Claims for State Fiscal Years 2005 and 2006

Executive Summary

In our review of community-based Medicaid administrative costs that the Connecticut Department of Social Services (the State agency) claimed for State fiscal years 2005 and 2006, we found that the State agency’s claims totaling $19.8 million may not have fully complied with Federal requirements. The State agency claimed reimbursement from CMS for administrative case management activities provided by contracted organizations. Because the State agency made omissions and deviations from acceptable practices when calculating its claims and was unable to provide adequate documentation, we were unable to express an opinion on the claims’ allowability.

We recommended that the State agency draft its future contracts to identify and properly value the amount of administrative case management activities and work with CMS to determine what portion of the $19.8 million was allowable under Federal requirements. The State agency agreed with our recommendations.

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