Delaware overpaid a hospital $175,000 in Medicaid MU incentives

The Delaware Department of Health and Social Services made an incorrect Medicaid incentive payment to one hospital, totaling $175,000, according to a report from the Department of Health and Human Services' Office of Inspector General (OIG).

Delaware paid $14 million in Medicaid Meaningful Use incentive payments to eligible professionals from 2011 through 2013 and $13 million to seven hospitals. The OIG reviewed the hospital payments, and subjected to further review the four hospitals that had each received payments of more than $1 million.

The review found that three of the hospitals had been paid correctly, but one received $2,017,584 when it should have received $1,842, 849, resulting in an overpayment of $174,735. The error occurred because the hospital understated the noncharity care charges in its Medicaid share percentage calculation and the state didn't validate the EHR incentive payment requested. The hospital said that it used its Medicare cost report to calculate the payment, but the report didn't include any amount for charity care charges; the hospital couldn't identify any source for the amount in its calculation.

The hospital has since repaid the overpayment, and Delaware has submitted the transaction to CMS. Still, the OIG expressed concern about the inaccuracy of payments being made pursuant to the Meaningful Use program.

"The Government Accountability Office has identified improper incentive payments as the primary risk to EHR incentive programs," the report states. "These programs may be at greater risk of improper payments than other programs because they are new and have complex requirements."

This OIG audit is one of a series of such audits being conducted. The Delaware overpayment is relatively small compared to mistakes made by other states. Oklahoma, for instance, made overpayments of more than $888,000, while Arkansas incorrectly paid $12 million and Texas incorrectly paid more than $15 million. 

In contrast, both Florida and the District of Columbia have made payments correctly.

To learn more:
- here's the report (.pdf)