DHS, Dinged for Payment Problems, Will Repay $3M to Feds

DHS, Dinged for Payment Problems, Will Repay $3M to Feds

The Arkansas Department of Human Services has agreed to repay about $3 million to the federal government after an audit found widespread problems with a specific type of Medicaid payment made to providers as part of the Affordable Care Act.

The ACA, commonly known as Obamacare, required states to pay increased rates to eligible providers in 2013 and 2014 to encourage participation in the Medicaid program. The federal government paid 100 percent of the supplemental payments, which totaled more than $73 million in Arkansas, according to a report released this month by the U.S. Department of Health & Human Service's Office of Inspector General.

Almost 9,000 of these supplemental payments were made in Arkansas. When the OIG reviewed a sample of 120 payments, it found that only 16 of them had been done correctly. 

"For 88 of the remaining 104 supplemental payments, Arkansas incorrectly calculated the amount of the payments," the OIG concluded. "An additional six supplemental payments were correctly calculated but were made to ineligible providers. The remaining 10 supplemental payments were both calculated incorrectly and were made to ineligible providers."

The OIG estimated that the state "improperly received at least $7.1 million" from the federal government to cover the improper payments, and recommended that the state repay approximately $3 million.

"Arkansas concurred with our findings and stated its commitment to working with [the Centers for Medicare & Medicaid Servces] to resolve any monetary paybacks identified in the report," the OIG wrote.

Amy Webb, spokeswoman for DHS, confirmed that the department would be repaying the money out of its existing Medicaid budget. The program, which she said was designed to make sure that primary care physicians and pediatricians were paid as much for providing specific services to Medicaid patients as for Medicare patients, no longer exists.

It is not unusual for the Office of Inspector General to identify problems with state Medicaid compliance, often in much larger dollar amounts. Other states that have been dinged for noncompliance with various regulations this year include New York, Kansas, Kentucky, North Carolina, Texas, Oklahoma, Iowa, California, New Jersey and Ohio.