tci Medicare Compliance & Reimbursement - 2005 Issue 23

ENFORCEMENT WATCH: The Big Payback: OIG Says OK Owes For Overages

An audit of Medicaid billings proves costly for state.When the feds order hefty paybacks from already meager state Medicaid budgets, providers will ultimately pay the price.The Oklahoma Department of Human Services, which administers the state's Medicaid program, must pay back the federal government more than $11 million for unallowable and wrongly categorized Medicaid claims, according to a recent Health and Human Services Office of Inspector General report.From 1997 to 2003, the OKDHS inappropriately charged the federal government $39.75 million in targeted case management costs as administrative costs, the OIG says. Targeted case management costs are...

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