tci Medicare Compliance & Reimbursement - 2003 Issue 7

Medicaid: IMD BILLING CAN STILL VEX STATES

Texas and California are the focus of the HHS Office of Inspector General’s latest reckonings of whether or not state Medicaid agencies properly block federal payments for most residents of institutions for mental diseases. The ongoing series of reviews is designed to ensure that states aren’t claiming federal financial participation under the Medicaid program for IMD residents between the ages of 21 and 64 — a class of patients for which, under longstanding Medicaid policy, federal payments aren’t available. The results: Texas claimed just over $500,000 in improper FFP for IMD residents between 1997 and...

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