Article archive / January 1, 2014
Originally published: . Volume 5, No. 5. Source pages: 4.
The Legislative Auditor, Daryl Purpera, found that the Department of Health and Hospitals (DHH) paid Medicaid fees for individuals who were deceased. A report to John A. Alario, Jr., President of the Senate, and Charles E. “Chuck” Kleckley, Speaker of the House of Representatives, noted “DHH paid approximately $1.85 million in participant fees for 1,727 deceased individuals in the Louisiana Behavioral Health Partnership and Bayou Health programs between February 1, 2012, and June 30, 2013.”
The report provided the results of the analysis on Medicaid participant fees paid by the Department of Health and Hospitals for deceased individuals. Purpera’s group obtained payments made by DHH for participants in the Louisiana Behavioral Health Partnership and Bayou Health programs and compared them to the listing of deceased individuals obtained from the DHH – Center of State Registrar and Vital Records (Vital Records).
Based on the results of our analysis, DHH does not have a sufficient process in place for identifying deceased Medicaid participants in a timely manner. Since February 2012, DHH has paid the entities administering the plans within the programs $1,849,474 in participant fees for deceased individuals. Of this $1,849,474, Magellan Health Services which is associated with the Louisiana Behavioral Health Partnership received $257,964 (14%) and the five entities associated with the Bayou Health program received $1,591,510 (86%), noted the report. Based on the results of our analysis, DHH does not have a sufficient process in place for identifying deceased Medicaid participants in a timely manner.
Ruth Kennedy, Medicaid Director, said she concurred with the report. She also said that the $1.85 million overpayment identified by Purpera’s office “represents a tenth of one percent of the total per member per month (PMPM) premiums paid during the review period…”
She said the office would recoup the payments from the Managed Care Organizations by March 31, 2014.
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