Federal auditors estimate Tennessee claimed at least $59.3 million in unallowable Medicaid case-management reimbursement; the state did not concur
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What happened
HHS Office of Inspector General audit A-07-24-03259, issued September 23, 2026, reviewed Tennessee Division of TennCare claims for targeted case management services in federal fiscal years 2021 through 2023. Of 150 sampled grouped line items, 43 were unallowable because enrollees did not meet the eligibility criteria for the target group in the Tennessee State plan; 30 of those involved early intervention case management where the state did not assess whether enrollees were at serious or imminent risk of entering State custody. OIG estimated at least $59.3 million (federal share) was unallowable and recommended a refund and a procedure change. Tennessee did not concur with either recommendation.
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Response
Tennessee did not concur with either of our recommendations.
What happened next (0)
No outcome recorded yet.