Auditor: North Carolina Medicaid overpaid $100M+ in claims

The North Carolina Department of Health and Human Services overpaid Medicaid providers by more than $100 million in fiscal year 2018, according to a state audit.

Advertisement

State Auditor Beth Wood found that the department made about $71.7 million in overpayments to Medicaid providers in 2018. In that year, the department processed more than 84 million fee-for-service claims totaling $7.93 billion.

The audit reviewed 726 fee-for-service payments totaling about $45.9 million, and found 14, or 1.9 percent of the payments, were erroneous. Errors occurred because of clerical mistakes and inadequate documentation, the state said.

In addition, auditors found the department made an estimated $29.1 million in Medicaid payments for ineligible beneficiaries in 2018 due to inaccurate and inadequate documentation.

For the full audit report, click here.

More articles on payers:
BCBS of Texas to open primary care clinics: 5 things to know
128,000 kids lost health insurance in Tennessee over 2 years — Here’s why
Pennsylvania woman denied coverage for sepsis-related foot amputation

Becker’s 3rd Annual Fall Chief Pharmacy Officer Summit is the top tier event that the people leading the future of pharmacy convene. This 3-day event is built specifically for Chief Pharmacy Officers and senior pharmacy leaders. The sessions examine the workforce, financial and clinical priorities shaping pharmacy today. Becker’s is where candid discussions flourish and new ideas thrive. Becker's 3rd Annual Fall Chief Pharmacy Officer Summit

Advertisement

Next Up in Legal & Regulatory Issues

Advertisement

Comments are closed.