22 pages matching paid claims in this book
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THREAT OF POTENTIALLY SEVERE FISCAL PENALTIES
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administrative costs AFDC Alabama APPENDIX II APPENDIX believe claims paid claims processing errors claims processing review claims processing sample corrective action activities corrective action plans corrective action program disallowances dollar effective eligibility determinations eligibility review eligibility sample eligible for Medicaid erroneous payments examined example Federal Medicaid regulations Federal regulations Federal sharing fiscal penalties fiscal sanctions funds HCFA MQC reviewers HCFA regional offices HCFA reviewers HCFA subsample HCFA's HHS agreed identified implementation improve incentives independent ineligible Louisiana Medicaid eligibility Medicaid plan Medicaid program Medicaid Quality Control misspent MQC corrective action MQC data MQC file MQC program MQC system MQC unit MQC's Office of Quality Oklahoma paid claims percent problems processing and third-party program weaknesses quality control program re-review recipients recovery efforts result review criteria review month Secretary of HHS State's Medicaid statistical sample stratum target error rate third-party liability reviews verification Washington