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.

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.

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