A surgical clamp holding money.The government is falling short in its job to collect hundreds of millions of dollars in Medicaid overpayments, according to a report released this month by the Department of Health and Human Services’ Office of the Inspector General.

The job of collections falls to the Centers for Medicare and Medicaid Services and according to the report there’s about $226 million in Medicaid overpayments that have gone to 11 states.

As of December 2012, CMS reported collecting $987,481,600 of the $1,213,085,167 in overpayments issued between fiscal years 2000 and 2009, according to the report. “However, CMS had not collected the remaining $225,603,567 because it had not always proceeded with the collection process in a timely manner,” the report notes.

OIG made the following recommendations:

  • Collect the remaining $225,603,567 that is due the federal government.
  • Review and address delays in resolving OIG audit recommendations and promptly pursue corrective actions.
  • Maintain adequate documentation to support the collection of overpayments in accordance with OMB Circular A-50 and CMS standard operating procedures.
  • Educate the states about their responsibility to report overpayments on the correct line of the CMS-64 to improve oversight of the reporting process.

In its response, CMS said it failed to collect some overpayments because additional review of the claims was needed, according to the report.

States affected are: Indiana, Illinois, Kansas, Louisiana, Missouri, New Jersey, Oregon and Pennsylvania. CMS is working to collect overpayments to Medicaid providers in Florida, New York and Massachusetts.

Click here to read the entire report.