Mass: Medicaid to audit providers

Thursday, March 21, 2019

BOSTON – MassHealth, the Massachusetts Medicaid program, has begun auditing HME providers. The audits, which are being conducted by Optum and the MassHealth Office of Long Term Support and Services, are in response to an April 2017 report that found $206,000 in improper payments were made to suppliers on a variety of claims. MassHealth anticipates conducing two audits per month until all suppliers have been audited, according to a blog from the van Halem Group. Suppliers should expect to have 100 patient claims reviewed; and be able to produce appropriate licenses and employee records. Documentation not available at the time of the audit can be submitted at a later date.