Behavioral health providers contest Optum, Maryland refund figures 

In tandem with the Maryland Department of Health, Optum announced a recoupment schedule on Nov. 17 for behavioral health providers to refund overpayments to state Medicaid and health programs. 

The department is looking to recoup over $359 million in alleged overpayments caused by a "system failure," according to The Baltimore Sun. Optum has managed the state's billing system for behavioral health providers since 2020. 

While some providers have already begun to repay the state, some are questioning whether the recoupment figures presented by Optum and the state are accurate. 

“We have to be able to check Optum’s math," Lori Doyle, public policy director at Community Behavioral Health Association of Maryland, told the Sun. "Unfortunately, their system is a mess. Our numbers are pretty far apart — what Optum thinks we owe and what providers think they owe."

An Optum spokesperson told Becker's that the final phase of recoupment — providers who received overpayments from Jan. 1, 2020 to Aug. 3, 2020 — should begin in the spring of 2022. The health department also implemented a debt forgiveness program for providers who owe less than $10,000. 

"Our platform is promptly paying providers for the critical care they deliver," the spokesperson told Becker's. "As Optum and MDH have made clear, providers currently have the claims information necessary to balance their books and begin repayment of any overpayments owed to Maryland. We continue to offer providers one-on-one technical support to assist in reconciling payments and are working to provide comprehensive claim information in a more-consolidated, user-friendly format."

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