Corporate Compliance

Report: Ohio Medicaid overpaid pharmacies by $69 million

Compliance Monitor, June 15, 2005

An independent study of the Ohio Medicaid program revealed that pharmacies were overpaid by $69 million over a five-year period, the Associated Press (AP) reported June 13.

The report linked the majority of the problem to a 2003 update of the payer's computer system for paying pharmacy claims. Now that the problem has been identified and the system fixed, Medicaid officials expect to recover most of the missing funds, the AP reported. The study reported more than 1.2 million duplicate claims paid between 2000 and 2004.

The independent study, conducted by the Ohio Commission to Reform Medicaid, was a response to a January report from the state's inspector general that showed the agency failed to collect millions in overpayments. The inspector general's report prompted the Ohio Department of Job and Family Services to develop an aggressive campaign to correct problems and collect overpayments, the AP reported.

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