CMS is currently behind on collecting $225.6 million in Medicaid overpayments, most of which was paid to two Illinois hospitals, according to a report from the HHS' Office of Inspector General (pdf).
The OIG looked at 147 audit reports issued between 2000 and 2009, finding that a few states needed to return Medicaid overpayments issued by the federal government. The overpayments totaled $1.2 billion.
As of December 2012, CMS had collected only $987.5 million of that total, citing that "it had not always proceeded with the collection process in a timely manner," according to the report.
Of the $225.6 million to be recouped, $144.8 million must come from Illinois. Illinois overpaid the University of Illinois Hospital & Health Sciences System in Chicago $140.3 million in Medicaid disproportionate share hospital payments, while Mount Sinai Hospital in Chicago was overpaid $4.5 million in Medicaid DSH funds.
Illinois' Department of Healthcare and Family Services, which encompasses the state Medicaid program, told the Chicago Tribune that it "strongly disagrees with the contention that money should be refunded to the federal government and will continue to vigorously contest this matter."
The OIG recommended CMS collect the remaining overpayments, address delays in resolving OIG audits, maintain better documentation to collect overpayments and educate states about their responsibility to report overpayments. CMS agreed with the OIG's recommendations, but clarified the remaining overpayments have not been collected due to states disagreeing with the findings.
The OIG looked at 147 audit reports issued between 2000 and 2009, finding that a few states needed to return Medicaid overpayments issued by the federal government. The overpayments totaled $1.2 billion.
As of December 2012, CMS had collected only $987.5 million of that total, citing that "it had not always proceeded with the collection process in a timely manner," according to the report.
Of the $225.6 million to be recouped, $144.8 million must come from Illinois. Illinois overpaid the University of Illinois Hospital & Health Sciences System in Chicago $140.3 million in Medicaid disproportionate share hospital payments, while Mount Sinai Hospital in Chicago was overpaid $4.5 million in Medicaid DSH funds.
Illinois' Department of Healthcare and Family Services, which encompasses the state Medicaid program, told the Chicago Tribune that it "strongly disagrees with the contention that money should be refunded to the federal government and will continue to vigorously contest this matter."
The OIG recommended CMS collect the remaining overpayments, address delays in resolving OIG audits, maintain better documentation to collect overpayments and educate states about their responsibility to report overpayments. CMS agreed with the OIG's recommendations, but clarified the remaining overpayments have not been collected due to states disagreeing with the findings.
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