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July 27, 2012

Feds seek $9M from DHHS

The Department of Health and Human Services overbilled the federal government by $9.2 million for Medicaid benefits, and now could be forced to repay that money. The news comes one day after DHHS said it had to refund $4 million in food assistance benefits.

According to a report by the U.S. DHHS' Office of the Inspector General, Maine from 2005 to 2009 overbilled the Centers for Medicare and Medicaid Services for the MaineCare program, the Bangor Daily News reported. The state used the wrong federal match on 90% of the more than 637,000 claims paid to health care providers that were reviewed by the inspector general. The federal match fluctuates based on several factors, including stimulus funding and the state's per capita income. The state and federal government share funding of MaineCare.

The state is negotiating with the feds to lower the repayment amount, saying it might have underbilled for MaineCare since 2009. The $9.2 million represents about 1% of the $750 million the state spent on its portion of MaineCare costs in fiscal year 2012, according to the paper.

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