Michigan: Medicaid wants money back—but how much?

Monday, February 25, 2013

LANSING, Mich. – A new report has found that computer system errors led Michigan’s Department of Community Health to make millions of dollars in Medicaid overpayments, and now HME providers are wondering how the state's recoupment efforts will affect them.

A Jan. 3 report issued by the Michigan Office of the Auditor General found $2.3 million in improper Medicaid payments for DMEPOS after examining claims from Oct. 1, 2009, through June 30, 2012.

“We hope it's a short window in terms of how long (the overpayments) have been going on so that it doesn’t inconvenience providers,” said Barry Cargill, executive director of the Michigan Home Health Association.

Improper payments to HME providers included $357,000 for incontinence supplies through double payments and payments to providers who didn’t win Michigan Medicaid’s competitive bid for those supplies. Another chunk was $641,000 in duplicate payments for HME.

“There were some duplicate payments because there just weren’t edits in place to catch things," said Laura Hirst, audit division administrator. “One of the big issues is that Medicaid is the payer of last resort, and some expenditures came through that they paid that Medicare should have paid.”

The state is now beginning to take steps to recoup the overpayments and correct its computer system. At press time, it was unclear how much of the overpayments to HME providers would be recouped.

Angela Minicuci, public information officer at the Michigan Department of Community Health, couldn’t comment on recoupments, except to say it would so if it was “appropriate and cost effective.”