EXECUTIVE SUMMARY:

Our objectives were to analyze Texas’s Medicaid Graduate Medical Education (GME) payment formula and the methods Texas used to establish the amount of funds that individual hospitals would receive and to determine whether (1) Texas followed the approved State plan in administering the Medicaid GME program and (2) intergovernmental transfers (IGTs) included any program funds. The State made unallowable Medicaid GME payments to ineligible hospitals totaling $318,778 ($175,323 Federal share). We recommended that Texas refund $318,778 ($175,323 Federal share) to CMS for the overpayments made to ineligible hospitals and review the eligibility of each teaching hospital annually.  Texas partially agreed with our findings and recommendations.  State officials have recouped $256,735 and plan to recoup an additional $14,739. State officials will review the remaining $47,304 and recoup any unallowable amounts.