In part, that was because only 25 of the 161 audits found any overpayments, the inspector general's office concluded. Another 102 of the audits turned up no problems with the providers' payments, and 34 were still ongoing as of Feb. 1.
The HHS inspectors found that a major weakness in the system appeared to be the quality of the data from which another set of CMS contractors selected its potential list of audit targets.
Between January and June 2010, the review Medicaid integrity contractors turned up 113,378 providers who potentially could have had overpayments, based on Medicaid payment data that contained numerous examples of missing or inaccurate information. Of those potential targets, the CMS selected 244 providers for audit, and then assigned audit Medicaid integrity contractors to review 161 of them.
In other words, only 25 of the potential 113,378 audit targets were ever shown to have received overpayments, the report says.
The CMS responded that it has several initiatives under way to improve audit-target selection, including improving the data that review Medicaid integrity contractors use to identify the initial list of potential targets.