Monday, September 24, 2012

HHS Pledges to End Medicaid Overpayments



According to the Committee on Oversight and Government Reform, the federal Centers for Medicare  and Medicaid Services (CMS) had been planning to continue to severely overpay the State of New York for services provided, and in some cases not provided, at its developmental centers for the next five years. The State-operated developmental centers, which house and treat individuals with developmental disabilities, were receiving Medicaid payments in excess of $5,000 per patient per day, a rate ten times greater than similar privately operated facilities.
"...A House Oversight and Government Reform Committee staff report estimated a $15 billion aggregate overpayment to the controversial centers over the past two decades. The report was released ahead of a hearing of the House Oversight and Government Reform Subcommittee on Health Care."
The Oversight Committee says that the Department of Health and Human Services has pledged to end those Medicaid "overpaynments," but not before issuing the scathing report that reveals, at best, rampant corruption at Medicaid and HHS and stated that:
"...Penny Thompson, CMS’s Deputy Director of the Center for Medicaid and CHIP Services, told the Subcommittee that CMS intends to reduce the artificially high federal Medicaid payments to New York developmental centers to one-fifth their current level, stating: 'We’re still finalizing those methodologies and numbers … but I think you can expect to see a rate that’s at about one fifth of its current level'...”
According to testimony before the Committee the payments to New York agencies amounted to the total Medicaid budgets of 14 other states.
“It’s good that CMS changed its mind and finally agreed to take a firm line against egregious federal Medicaid overpayments today, but it’s unfortunate that it has taken so many years to start trying to fix the problem” said Rep. Paul Gosar, R-Az. Gosar is a licensed dentist who has worked with Medicaid patients. “The Committee will hold CMS to their pledge and make sure they follow through on the plan of action laid out today.”
Thompson also told the Committee that CMS is going to assess its ability to recover  money that was improperly received by the State through the excessive developmental center overpayments.
“...The payments for New York’s developmental centers are excessive and unacceptable.  Once we have agreed upon a finalized payment methodology with New York, CMS will review past overpayments, and determine if there are additional funds that need to be returned to the U.S. Treasury...”