CMS Should Improve Its Policies and Procedures for the Oversight of States’ Reported Medicaid Expenditures to Better Protect the Financial Integrity of the Medicaid Program (A-06-23-09006)

After each quarter ends, states report to the Centers for Medicare and Medicaid Services (CMS) their Medicaid expenditures and the associated federal share on the Form CMS-64.  Due to the variation in states’ Medicaid programs and an increasing number of different federal matching rates, CMS’ review of reported expenditures has become increasingly complex.  This audit determined that CMS did not consistently follow its policies and procedures related to the oversight of Medicaid state expenditures reported on the CMS-64.  Additionally, some CMS policies and procedures were not sufficient to protect the financial integrity of the Medicaid program.

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