Providers in the state of Wisconsin may owe the federal government $22.8 million in Medicaid overpayments, the Wasusau Daily Herald reported.
The overpayments were allegedly made to 27 residential care centers (RCCs) caring for disabled adults between October 2004 and September 2006 under a state screening and diagnostic program known as HealthCheck.
Only $1.1 million of the payments were allowable, according to the audit. The Office of the Inspector General of the U.S. Department of Health and Human Services claimed that a state agency used an inappropriate methodology to collect payments. In particularly, the state relied on salary estimates for HealthCheck outreach workers that it could not properly verify, and accounted for 90 percent of its total expenses.
According to the OIG's report, Wisconsin greatly boosted its HealthCheck charges on the recommendations of a consultant.
State officials rejected the conclusions of the OIG. "Each youth who receives mental health services in RCCs has severe emotional disturbance that requires consistent application of a behavior treatment plan throughout the day and night by youth care workers and social workers," Wisconsin Department of Health Services Administrator Kitty Rhoades responded. "Including a substantial portion of their salaries in the RCC Medicaid reimbursement rate is not unreasonable."
The OIG has claimed more than $120 million in recent Medicaid overpayments, including more than $80 million in Alabama, FierceHealthFinance previously reported.
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