Family and Children's Medicaid MA-3530 CORRECTIVE ACTION AND RESPONSIBILITY FOR ERRORS

REVISED 10/01/10 – CHANGE NO. 11-10

I. INTRODUCTION

Nearly 65% of Medicaid program service costs come from federal funds. The Centers for Medicare and Medicaid Services (CMS) prescribes limits on the use of federal funds provided to states for Medicaid expenditures and time limits for claiming federal financial participation (FFP). State expenditures under the Medicaid program are audited continuously by CMS financial staff and by onsite state auditors. Selective audits may be performed by the U.S. Office of the Inspector General and the General Accounting Office.

This section provides instructions for retroactive authorizations or changes to correct prior actions to assure that an applicant/recipient (a/r) receives accurate benefits and that federal funds are claimed appropriately.