Auditors flag improper billing at Oregon Health Plan

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An audit conducted by the Oregon Health Authority found that Oregon Health Plan, the state's Medicaid program, improperly issued claims to providers for in-home care and transportation despite patients being hospitalized at the time, according to The Lund Report

According to the audit, the authority found more than $52,000 in improper payments and about $1.6 million in payments that had a high probability of being improper. 

The audit analyzed 25 extended hospital stays over three years, which included 134 claims filed to Oregon Health Plan. Of the stays, 118 claims were filed improperly and 80 percent had improper payments, according to The Lund Report

The report noted that while improper claims made up a small portion of the state's $30 billion in Medicaid expenditures over the audit's three years, it still presents the possibility that claims could continue to be issued improperly. 

"While the proportion is small, there is still the risk of improper payments, which represent significant dollars that could be redirected to providing services to Oregonians," according to the report. 

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