Texas may have falsely claimed millions in uncompensated care payments; agrees to refund

Texas agreed to refund about $11 million to the U.S. government for underreported uncompensated care payments following an audit from the HHS Office of Inspector General, but another $33.78 million remains in dispute, according to a September OIG report. The state has also agreed to tighter reporting methods going forward.

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The Texas Health and Human Services Commission disputes the $33.78 million figure, which the OIG report says remains valid because the state agency did not reduce hospitals’ actual UC costs by Medicare payments the hospitals received. The federal government share of the $33.78 million is $19.66 million, according to the OIG.

The $11.05 million figure Texas has agreed to refund relates to the federal government share of a total amount of $18.9 million the OIG says Texas claimed incorrectly either by not refunding the full federal share of overpayments or not collecting overpayments it had identified. 

All the claims relate to the period between Dec. 12, 2011, and Sept. 30, 2016, and focused on Texas’ total of $16.9 billion in UC payment claims, of which the federal share was $9.86 billion.

The full report can be found here.

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