The Missouri Medicaid Audit & Compliance Unit (MMAC) issues final decision letters to providers after conducting reviews of post-payment claims. Providers must be aware that the overpayment amount detailed in their final decision (demand) letter is a sanction according to 13CSR 70-3.030. Providers are prohibited from submitting on-line claim adjustments for erroneous payment to correct the overpayment. Providers must submit payment to MMAC Unit via check or electronic transfer from future remittance advice.
Questions and concerns regarding repayment can be directed to the MO HealthNet Division Provider Education Unit representative.
MMAC enforces this sanction per authority of 13 CSR 70-3.030.