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Healthcare Business News
 

Feds: Fla. owes millions in Medicaid overpayments


By Associated Press
Posted: April 5, 2013 - 5:45 pm ET
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Federal health officials say Florida owes millions in Medicaid overpayments, according to a report released Friday.

The Florida Department of Children and Families identified $22.3 million in Medicaid overpayments between 2007 and 2010 and the federal share is about $12 million. The feds initially said the state should return all $12 million, but amended their recommendation after state officials said they had only collected $4 million of those funds and should not be expected to repay funds they have not yet recouped, according to a report by the Department of Health and Human Services inspector general.

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After talking with the state, federal health officials agreed the state should repay $2.2 million, which is the federal share of what has already been collected. A DCF spokeswoman said the agency has set aside $1.4 million to return, so far. Federal health officials also recommended the state agencies improve coordination.

DCF determines Medicaid eligibility but the Florida Agency for Health Care Administration is the sole recipient of federal funds for the program.

The report says the Agency for Health Care Administration did not return the federal share of Medicaid overpayments because it failed to adequately coordinate with (DCF) to ensure that Medicaid overpayments were reported in accordance with federal and state requirements.

State health officials did not immediately comment Friday.

Most Medicaid overpayments result from mistakes made by applicants but, there are also mistakes made by the agency and intentional fraud. Once DCF realizes it has overpaid someone, it can be difficult to recover the money since many recipients are already in financial hardship.

The agency can garnish future benefits but not by more than 10 percent. DCF officials must also be careful not to place an applicant back into financial hardship because of a hefty overpayment recoup, DCF spokeswoman Carrie Hoeppner said.

In cases of fraud, it can be difficult to recoup money if the perpetrators are in prison, she said.

"Either way, while we have success recouping overpayments, it can be a slow process as the individual is indigent or incarcerated," she said.


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