Corporate Compliance

Louisiana claims nearly $20M in unallowable costs for Katrina evacuees

Healthcare Auditing Weekly, October 28, 2008

A report from the OIG’s Office of Audit Services (OAS) found the state of Louisiana claimed an estimated $19.8 million for services from East Louisiana State Hospital. The claims did not comply with state or federal laws, nor did they comply with approved terms of the state’s uncompensated care pool (UCCP) plan.
 
The UCCP plan is a CMS-approved plan meant to reimburse providers for services given to Hurricane Katrina and Rita evacuees without other coverage.
 
The OAS used a 100-patient sample for the audit.  It discovered that 98 patient claims, a $7.8 million share of the $8 million in costs claimed for services provided to the audit sample, were unallowable. These costs were unallowable because:
  • The patient’s care was not covered by Medicaid
  • The patient did not receive services on the dates claimed
  • The patient’s costs were paid by other sources, or
  • The patient’s costs were reimbursed from the Hurricane Rita uncompensated care pool but who were not evacuees.
The OIG recommended the state refund CMS the estimated $19.8 million in unallowable costs. The state did not agree with the OIG’s findings.

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