Auditor Finds CMS Failed to Provide Adequate Documentation

The Office of Inspector General has found that Centers for Medicare and Medicaid Services (CMS) failed to properly document more than $7 million it collected from states that were overpaid for Medicaid claims, an irony that should not be lost on healthcare providers who frequently are told by CMS contractors that their own Medicare claims lack sufficient documentation.

The unprovable $7 million is but a drop in the ocean when it comes to collecting Medicaid overpayments from states. The OIG’s Office of Audit Affairs found that CMS has yet to collect more than $225 million in overpayments “because it had not always proceeded with the collection process in a timely manner,” the auditors found. Following the audit, released last week, CMS has pledged to be more diligent collecting overpayments.