Carolina Journal reports in recent reports from State Auditor’s office on North Carolina’s administration of Medicaid:
The state Department of Health and Human Services improperly paid more than $100 million in Medicaid claims during fiscal year 2018, State Auditor Beth Wood reported.
An audit released Monday, April 8, highlighted a series of errors and weaknesses in DHHS operations. Some were repeat findings from earlier audits and weren’t corrected despite recommendations from the auditor.
Auditors noted the overpayments to providers, along with benefits paid to ineligible recipients, reduced the money available to pay for Medicaid recipients’ services.
The department processed more than 84 million payments totaling $7.93 billion in 2018. Auditors’ samples found some claims lacked documentation to show the services were rendered. Others contained medical coding errors which resulted in underpayments.
“As a result, the Department overpaid an estimated $71.7 million that could have been used to provide additional services to other eligible beneficiaries or reduce overall program costs,” the audit stated.
Errors resulted from clerical mistakes and inadequate documentation. The same findings were noted in a 2017 statewide audit.
Auditors recommended DHHS management to analyze each error and implement corrections immediately.
Read more here.
Beth Wood will be speaking at the John Locke Foundation about these reports and state and federal Medicaid reform on Monday, register for her talk here.
