CMS has formally given the state of Louisiana a pretty nasty fiscal demand: The agency has told state officials that during the mid-1990s, it overpaid state-run charity hospitals for care provided to the uninsured. Now it wants $362 million back.

Under the terms of the CMS request, Louisiana has a year and a half to repay the existing $362 million. Sadly, even if it does, that's not the end of the dispute. In total, CMS says, the state's Medicaid program was overpaid by about $800 million more than 10 years ago, though not all payments went to public hospitals.

Officials say they've known about the alleged overpayment for a while, and are negotiating with the feds in an effort to cut down the repayment number. The overpayments were actually discovered several years after they were made, when cost-reports made to CMS by hospitals suggested that something was wrong.

To learn more about the dispute:
- read this Kaiser Health News piece [1]