State audit: Nebraska failed to act on overpayment referrals

More than 12,000 overpayment referrals are sitting untouched in the Nebraska Department of Health and Human Services' (DHHS) "overpayments mailbox," according to a state audit released last week.

The referrals represent more than $10 million in potential overpayments, although the audit reported that the state had recouped approximately $3.6 million in 2015. Of the 12,000 unaddressed referrals, 239 were associated with Medicaid overpayments. The remaining referrals were linked to other state programs such as children and family services and nutritional assistance.

The state audit indicated that many of the referrals were either ignored because of the backlog or not addressed in a timely manner thanks to DHHS policies that failed to clarify how staff should prioritize unworked claims. Auditors found that 60 percent of the referrals in the overpayments mailbox were unworked. Those that were worked on were often handled inappropriately or in violation of department policies.

"Without adequate controls and resources to work suspected overpayments, timeframes set by Federal regulations will not be met," the report stated. "Overpayments not worked timely have a lesser chance of collection. Overpayments not worked at all will have no chance of collection."

Top DHHS officials told Omaha.com that the department was addressing ways to improve recovery efforts.

Earlier this month, a memo from the White House budget director called for "a more aggressive strategy" to combat improper payments within government healthcare programs. Additionally, the Government Accountability Office has counted improper payments among the key issues facing the Medicaid program.

For more:
- here's the Nebraska audit
- read the Omaha.com article

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Improper payments among the four key issues facing Medicaid
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