tci Medicare Compliance & Reimbursement - 2005 Issue 36

Enforcement Watch: States May Be Overcharging For Medical Staff

Enhanced-rate payments not possible on certain overhead costs.Providers in states that charge the government more than their share of enhanced costs for skilled medical personnel could face paying millions in refunds.The California Department of Health Services should refund approximately $5.3 million to the federal government for allegedly overcharging for costs associated with skilled professional medical personnel and their supporting staff, the HHS Office of Inspector General (OIG) said in a Sept. 8 audit report.From Oct. 1, 2002 to Sept. 30, 2003, the state purportedly claimed federal Medicaid funding for overhead costs that weren't eligible for...

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