Hospitals bracing for deeper MaineCare audits
Maine hospitals are bracing for deeper audits of their services to MaineCare patients by a contractor that dentists say has issued unfair audits ordering them to pay back to the state sometimes financially ruinous amounts.
The Portland Press Herald reported the New York-based HMS has begun gathering information from the hospitals for its audit, which the state’s Department of Health and Human Services expects to receive in the coming months. The new audits are required under the Affordable Care Act through a system that pays auditors working for a private contractor more for each mistake found.
Jeff Austin, vice president of government affairs for the Maine Hospital Association, told the paper his organization is wary of the audit. Dentists have said the new auditing system resulted in unfairly steep fines for small clerical errors that Falmouth dentist Michael Dowling said don’t reflect the quality of treatment.
Rep. Richard Farnsworth, D-Portland, said fines so far total about $800,000 statewide, and some clinics have been slapped with more than $200,000 in penalties.
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