Texas received more than $95.3 million from Medicaid for services that did not qualify for reimbursement during the period from May 1, 2004 through Sept. 30, 2007, according an audit by HHS' Office of the Inspector General.
The OIG claims Texas did not calculate some supplemental physician payments to Austin-based University of Texas hospitals in accordance with federal and state requirements. The audit found UT facilities were erroneously reimbursed for services by providers who were not eligible for the Medicaid program or for services not eligible for federal reimbursement.
The OIG recommended the Texas Health and Human Services Commission refund CMS $57.8 million for federal overpayments.
University of Texas officials said the system plans to make restorations for overpayments in accordance with CMS' final decision.
This is OIG's second audit of supplemental physician payments to Texas hospitals. It plans to release one more audit later this year.