Nearly half of the five million claims auditors sampled between 2008 and 2010 had been improperly adjusted by Massachusetts health officials who filed claims from as far back as 1988 as current expenses.
HHS inspector general auditors discovered the state voided old claims with low reimbursement rates and processed new claims with the higher reimbursement rate currently in place.
In the inspector general’s opinion, Massachusetts should have to return the entire $106 million in Medicaid funds to the government and improve future adjustments.
More articles on payer issues:
Indiana Medicaid expansion update
Medicare beneficiaries’ claims wrongfully delayed, rejected
CMS sets standards for Medicaid managed care plan payments
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