CMS may seek $225 million in uncollected Medicaid overpayments

Share this article:

The Centers for Medicare & Medicaid Services should press states to repay about $225 million in Medicaid overpayments accrued over a 10-year period, according to a recent report from the Department of Health and Human Services Office of Inspector General (OIG).

As of December, CMS had recovered $987 million out of $1.2 billion in Medicaid overpayments verified during fiscal years 2000-2009, according to the OIG report released Feb. 20. The OIG audit review focused on 11 states with a “high dollar amount of sustained overpayments”: Florida, Indiana, Illinois, Kansas, Louisiana, Massachusetts, Missouri, New York, New Jersey, Oregon and Pennsylvania.

The OIG recommends that CMS collect the outstanding overpayments. CMS concurs in part with that recommendation, according to a response letter from Acting Administrator Marilyn Tavenner. However, CMS will review additional information provided by the states in question before making a final determination, Tavenner wrote.

In May, CMS adjusted regulations governing Medicaid overpayments made to long-term care operators and other healthcare providers. A proposed rule gave states 60 days to return overpayments resulting from fraud to the federal government, although providers said this would place an undue burden on them. CMS extended the repayment window to one year.

Share this article:

More in News

Bulk of Medicaid to be managed care in two years: Avalere

Bulk of Medicaid to be managed care in ...

More than three-quarters of Medicaid beneficiaries will be enrolled in a managed care plan as of 2016, according to an Avalere Health analysis released Thursday. The numbers reveal that managed ...

Nursing home asked for employee's personal information too often, jury rules

The human resources department of a Maine nursing home did not properly protect a former employee's personal identification information, a jury recently ruled.

Test could confirm sepsis within an hour

Nursing home residents might benefit from a new way of diagnosing and treating sepsis made possible by discoveries out of the University of British Columbia.