tci Medicare Compliance & Reimbursement - 2003 Issue 13

Managed Care: DUAL-ELIGIBLE BLUNDERS COMPLICATE MCO PAYMENTS

Florida managed Medicare companies were the lucky beneficiaries of a costly error by the Florida Agency for Health Care Administration, according to recent audit report from the HHS Office of Inspector General. The state health department made improper fee-for-service payments that managed Medicare plans should have paid, the OIG asserts in "Medicaid Fee-for-Service Payments for Dually Eligible Medicare Managed Care Enrollees" (A-04-02-07007). The watchdog agency recommends that Florida should refund more than $2.2 million to the Centers for Medicare & Medicaid Services for the overpayments, which involved beneficiaries who were eligible for both Medicare and Medicaid. Some of...

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