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Washington is the latest state found to have made incorrect payments pursuant to the Medicaid Meaningful Use program, resulting in net overpayments of $9,206,388, according to the Department of Health and Human Services Office of Inspector General.
The state made about $250 million in incentive payments from Oct. 1, 2011, through Dec. 31, 2014, according to an OIG report; of that, $120 million was paid to 87 hospitals. The OIG selected for further review the 20 hospitals that received a first-year incentive payment of more than $1 million. The state paid the 20 hospitals $61,129,006 through December 2014, and made additional payments to four of the 20 hospitals, totaling $2,653,486, as of Dec. 31, 2015, which the OIG also reviewed.
The OIG found that Washington’s state agency made incorrect payments to 19 of the 20 hospitals, resulting in the net overpayment. The state paid the hospitals incorrectly because it didn’t review supporting documentation from the hospitals to help identify errors in their calculations.
The OIG recommended that the state refund the federal government the $9.2 million in overpayments and adjust the 19 hospitals’ remaining incentive payments to account for the incorrect calculations, which will result in cost savings of $2,482,882 after Dec. 31, 2015. The state should also review the calculations of the hospitals not examined by the OIG to determine if any changes should be made to their payments, and review all supporting documentation provided by the hospitals.
The state concurred that corrections should be made, but disagreed with the actual amounts, arguing that the OIG used hospital accounting methods as its data source while the state used Medicare cost reports. The state also said that the OIG didn’t reconcile the two data sources. The OIG maintains that its data source was correct and its figures valid.
The audits are part of a series of reports focused on the Medicaid Meaningful Use program for hospitals. The majority of states audited thus far have been found to have made errors in the payments made.