tci Medicare Compliance & Reimbursement - 2005 Issue 34

ENFORCEMENT WATCH: Medicare May Dictate Medicaid-Allowable Costs

The OIG can involve Medicare FIs identity duplicate claims.Providers should make sure they follow the Medicare Provider Reimbursement Manual's requirements for their Medicaid cost reports, if their state regulations don't modify it.Las Cruces, NM for-profit nursing facility Casa De Oro claimed more than $103,000 in costs that were unallowable under state regulations and Medicare requirements, the HHS Office of Inspector General said in an audit released on July 21. The audit focused on Casa's fiscal year 2000 Medicaid cost report, which the state used to calculate reimbursement rates for Casa's claims from July 1, 2001 to...

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