Feds could order Florida's Medicaid program to repay $436M

HHS could force Florida Medicaid to repay the federal government $436 million for alleged improper reimbursement to Miami-based Jackson Memorial Hospital, according to Politico, which cites a draft report from the HHS inspector general.

In the inspector general report, the federal government claims Florida Medicaid wrongly paid hundreds of millions to Jackson Memorial between 2010 and 2014. Officials contend the funds weren't permitted under the Low Income Pool Program designed to reimburse the state's safety-net hospitals.

According to Politico, auditors said Jackson Memorial left out or underreported Medicare and Medicaid payments and incorrectly claimed some healthcare costs. Auditors also said state officials didn't create policies to "identify and correct instances in which hospitals overstated their cost limits."

The allegations are highlighted in the draft report dated from May and obtained by Politico. HHS could order the state to pay money back in a forthcoming final report. 

Meanwhile, Jackson Memorial — which received $1.8 billion in funds from the Low Income Pool program between 2010 and 2014, according to auditors — disagreed with many of the findings in the inspector general draft report in documents reviewed by Politico.

The hospital described the findings as "largely inaccurate, are based on erroneous assumptions, and misconstrue or mischaracterize documentation provided in the course of the audit." It contends recoupment by the federal government will harm the hospital and the uninsured and Medicaid patients it treats.

Jackson Memorial, a 1,550-bed nonprofit, tertiary care hospital, is one of the nation's largest public hospitals.

Read the full Politico report here.   


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