Florida's Refugee Medical Assistance Payments Were Generally Allowable

Why OIG Did This Audit

The Refugee Act of 1980 created the Refugee Resettlement Program (RRP) to provide for the effective resettlement of refugees and to assist them in achieving economic self-sufficiency after arriving in the United States. The Act provides Federal grants to States for cash and medical assistance, social services, and targeted assistance to help qualified refugees. Within HHS, the Administration for Children and Families, Office of Refugee Resettlement (ORR) runs the RRP program. In 2015 and 2016, ORR obligated $286 million and $417 million, respectively, to States for the RRP.

We selected for audit Florida's Department of Children and Families (DCF) because a previous OAS audit, as well as an ORR monitoring report, identified errors. DCF coordinates and oversees many of the services provided to refugees and entrants in Florida to help them become economically self-sufficient.

Our objective was to determine whether Florida's refugee medical assistance (RMA) payments were allowable in accordance with Federal and State regulations.

How OIG Did This Audit

Our audit covered 693,982 RMA capitation payments totaling $76.7 million, and 303,926 RMA fee-for-service (FFS) payments totaling $15.7 million that Florida made to beneficiaries from October 1, 2015, through September 30, 2017. From these payments, we selected for review two random samples of 100 capitation payments totaling $27,172 and 110 FFS payments totaling $532,952.

What OIG Found

Florida's RMA payments made on behalf of beneficiaries were generally allowable in accordance with Federal and State regulations; however, Florida made some unallowable payments. Of our 2 samples of 100 capitation payments and 110 FFS payments totaling $27,172 and $532,952, respectively, 208 were correct, but 2 FFS payments were not. For those two FFS payments, the RMA benefits were outside of the beneficiaries' eligibility periods. As a result, Florida made unallowable payments totaling $8,772.

These unallowable payments occurred because workers did not perform the required eligibility reviews in accordance with department procedures. The errors were not determined to be systemic in nature; therefore, we are not making any procedural recommendations.

What OIG Recommends and Florida Comments

We recommend that Florida refund $8,772 to the Federal Government.

In response to our draft report, Florida stated that it would refund $8,772 to the Federal Government.