DHHS loses track of Medicaid overpayments
State auditors estimate the Maine Department of Health and Human Services overpaid nursing homes and assisted-living facilities nearly $29 million through the state’s Medicaid program in the last fiscal year. That figure represents around 5.5% of $528 million in state and federal Medicaid reimbursements for that time, according to the Portland Press Herald.
The paper reported the department attributed the errors to computer and accounting problems discovered in 2006 that have not been fixed. For the period September 2010 through June 2013, a recent review by the state Office of the Controller found $36.4 million in overpayments.
Pola Buckley, the state auditor, told the paper that it’s not clear how much is owed to the state before that period and that the money was returned in some cases.
The latest estimates are part of a report to be presented Tuesday to the Legislature’s Health and Human Services Committee along with emergency legislation that would force the department to fix its computer systems to help reduce overpayments and collect past due overpayments. That work, the paper reported, has been done by hand for years.
Rick Erb, head of the Maine Health Care Association, which represents around 100 nursing homes and 100 assisted-living facilities, told the paper that keeping track of overpayments in order to return them to the state carries a cost for providers, as it requires either additional staff or hours.
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