GOV’T AUDIT INSIDER: WV healthcare agency to refund CMS $299,000 in overpayments
Healthcare Auditing Weekly, January 18, 2005
The West Virginia Bureau for Medical Services improperly claimed the federal enhanced rate for 38 individuals improperly classified as skilled professional medical personnel, according to an OIG audit report. As a result, the state agency received Medicaid overpayments for fiscal year 2003 totaling $296,485 for individuals and $2,875 for non-compensation expenditures that did not meet the criteria of skilled professional medical personnel. Although CMS and the state generally agreed with the findings, the state agency reclassified 11 individuals who were claimed and reimbursed at the federal enhanced rate for skilled professional medical personnel as Medicaid Management Information System operations personnel. The OIG recommends that the state agency refund $299,360 and implement procedures to properly classify skilled professional medical personnel. During the audit, the OIG did the following:
Click here to read the audit report, "Audit of Medicaid Payments for Skilled Professional Medical Personnel Reimbursed at Enhanced Rates - West Virginia," (A-03-04-00204) issued December 7, 2004.
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