OIG: Missouri pediatric psych facility owes $21.4M to Medicaid

The Department of Health & Human Services' Office of the Inspector General wants the state of Missouri to return $21.4 million in Medicaid payments made to the state-owned Hawthorn Children's Psychiatric Hospital, according to an OIG audit report

The hospital, which is operated by the state of Missouri, had failed to meet regulatory requirements in order to be able to accept payments from the Medicaid program, the OIG report said. 

According to the St. Lous Post-Dispatch,  Hawthorn Children's, which is located near the St Louis suburb of Pagedale, Mo., had failed to provide acceptable proof of required staffing and recordkeeping.

The audit covered the years 2005 to 2010, the Associated Press reported. The facility is the only freestanding pediatric psychiatric facility in Missouri.

The agency that oversees the hospital, the Missouri Department of Social Services, has been in recent managerial turmoil. Its former director, Alan Freeman, left the agency in May after only five months to return to his previous job in the private sector, according to the Associated Press. Freeman made the argument to the OIG that his agency would not pay back the money.

State officials claim they do not need to repay the money, claiming such regulations apply only to inpatient medical facilities that also accept Medicare patients. The OIG has rejected that argument.

The OIG has no power to compel Missouri to repay the money, but can refer the matter to the Centers for Medicare & Medicaid Services for collection.

To learn more:
- here's the OIG summary and report (.pdf)
- read the St. Louis Post-Dispatch article
- check out the Associated Press article

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