Wisconsin Inappropriately Withdrew Federal Medicaid Funds for Fiscal Years 2010 Through 2012

Wisconsin's Federal Medicaid withdrawals during FYs 2010 through 2012 did not fully comply with Federal and State regulations. The Wisconsin Department of Health Services (State agency) properly withdrew $13.6 billion of the $13.7 billion obtained in Federal Medicaid funds. However, the State agency inappropriately withdrew the difference of $89.6 million to pay for aggregate annual projected costs. According to the approved State waivers, these costs should have been paid for solely with State funds for the first 3 months of each calendar year during FYs 2010 through 2012.

Additionally, the State agency lacked formal policies and procedures for withdrawing Federal Medicaid funds from the Payment Management System (PMS) account.

We recommended that the State agency (1) refund $89.6 million to the Federal Government, (2) establish formal policies and procedures for withdrawing Federal funds from PMS for Medicaid in accordance with Federal and State requirements, and (3) ensure all Federal withdrawals from PMS that occurred after our audit period comply with Federal and State requirements. The State agency disagreed with all three of our recommendations.