Medicaid Clinical Laboratory Service Payments, Department of Public Health And Human Services : Performance Audit Follow-Up 2000

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Controls to Ensure Duplicate Payments Are Not Made We found the department did not have controls to ensure duplicate payments were not made to Medicaid providers for clinical laboratory services. We determined 4 of the 150 claims tested had duplicate services submitted and paid. We did not determine if claims in addition to our sample had duplicate payments submitted and paid.
Prior Recom mendation #3 We recommend the department help ensure duplicate payments are not made for clinical laborator
...y services by increasing the procedure codes reviewed to detect duplicate payment requests submitted by providers.
This recommendation i s partially implemented.
The department formed a committee to review duplicate payment status. The committee met, gathered additional information on duplicate payments, and requested staff be more aware of duplicate payments.
Department officials stated it would not be cost-effective to increase the number of procedure codes reviewed.
rnntrols to Fnsiire Cor rect Payment Method Is Used Audit work showed the department did not have controls to ensure changes in payment methods for clinical laboratory services were paid at the correct rate for 17 procedure codes.


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