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D.C. Health Department Did Not Adequately Document Medicaid Transportation Spending, Audit Finds
The Washington, D.C., Department of Health Medical Assistance Administration was unable to provide documentation that would legitimize the $16.3 million it spent last year to transport more than 8,000 Medicaid beneficiaries to doctor's appointments, according to an audit by the D.C. inspector general, the Washington Post reports. The audit found that 8,607 Medicaid beneficiaries filed 427,898 claims last year for transportation services and that the city paid 225 providers. However, the city health department had just 292 claim forms. The average annual cost for each beneficiary was $1,895. For the audit, the D.C. Inspector General Charles Willoughby examined a sample of 32 Medicaid beneficiaries who used the transportation services during May and June 2005 and found that while 385 claims were paid, 106 of them did not have adequate documentation. In addition, none of the six medical facilities that treated those beneficiaries were enforced by the city to submit "medical necessity forms," which identify Medicaid beneficiaries and what type of transportation they need. As a result of the lack of documentation, the city health department could not determine the number of authorized participants who used the program and whether the participants' medical conditions qualified them for transportation services. In addition, D.C. Council member David Catania, whose committee monitors the department, said his office could not locate some transportation companies listed as receiving money through the program. Willoughby said the lack of records "is a serious breach of basic internal controls." According to Catania, "There's absolutely fraud, and the way our Medicaid records are kept, we can't prove it." City Health Director Gregg Pane wrote in a response to the audit that his office acknowledges there are "profound management and financial challenges to overcome." He said he will implement the auditor's recommendations to establish a filing system, perform periodic reviews of the mandatory forms and require medical professionals to submit paperwork (Woodlee, Washington Post, 10/10).
"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
DC Directia de Sanatate nu au în mod adecvat Document Medicaid Cheltuielile de transport, de audit Gãseºte - D.C. Health Department Did Not Adequately Document Medicaid Transportation Spending, Audit Finds - articole medicale engleza - startsanatate
