AUGUSTA, Maine — The federal government wants Maine to repay more than $9 million that the Department of Health and Human Services overbilled in the Medicaid program over four years.
Maine splits the bill for the health insurance program, which covers low-income and disabled residents and is known as MaineCare in the state, with the feds. From 2005 to 2009, DHHS used an erroneous federal match rate and overbilled the Centers for Medicare and Medicaid Services by $9.2 million, according to a report by the U.S. Department of Health and Human Services’ Office of Inspector General, which investigates fraud, waste and abuse in the department’s programs.
The state is negotiating with the federal government to lower the refund amount.
DHHS used the wrong federal match rate on 90 percent of the 637,057 claims that the inspector general reviewed, according to the report. The errors occurred as DHHS adjusted previously paid claims from health care providers to reflect changing federal match rates.
The federal match can fluctuate based on a state’s per capita income and other factors.
The match rate fluctuated frequently with the influx of federal stimulus money, according to Stefanie Nadeau, director of MaineCare Services. The overbilling occurred under the state’s previous claims processing system, which since has been replaced, she said.
DHHS is looking for the feds to weigh in on whether the current claims system is properly calculating the match rate, Nadeau said.
“We want to make sure the way we configured our system today is appropriate,” she said.
While DHHS overbilled for some claims during the four-year audit period, it may have underbilled the federal government since 2009 as the match rate dropped and stimulus funds dried up, Nadeau said. The department is looking to settle on a refund amount somewhere in the middle, she said.
Once state and federal officials reach a figure, repayment options will be sorted out, Nadeau said.
The Office of Inspector General conducted fieldwork at DHHS from December 2011 to March 2012, according to the report. The Legislature has been periodically updated on the audit’s progress since last fall, Nadeau said.
The $9.2 million represents about 1 percent of the roughly $750 million the state spent on its share of Medicaid costs in fiscal year 2012.
In a separate incident, the federal government is asking DHHS to recoup roughly $4 million in federal funds overpaid to food assistance recipients.
The gang that can’t shoot straight rides again …
From 2005 to 2009, DHHS used an erroneous federal match rate and
overbilled the Centers for Medicare and Medicaid Services by $9.2
million,
Baldacci
There is plenty of blame to go around — the 9.2 million took place over 4 years on Mr Baldacci’s watch
The 4 million missspent between April and August of 2011 occurred on Mr LePage’s watch —
this 4 million was knowingly misspent while Ms Mayhew and crew attempted to rewrite a rule — John Martins spokesman of DHHS acknowledged that ” They could have been more proficient and efficient in getting the rules passed. Oh yeah then they waited another 12 months to acknowledge the mistake that they want the recepients to repay. I call this fiddling while Rome burns.
When do we start to hold Ms Mayhew and crew responsible ? Perhaps Mr LePage should have accepted her resignation last spring when it was offered. Oh yeah how does he replace her ?
This occurred in the period of 2005-2009!
Let me guess; this is all LePages fault!
Who would you like to blame? Obama?
Nah, going back I would say Bush. :-))))
If it wasn’t for cleaning up after Clintons mess there wouldn’t have been any. WJ Clinton, the ring leader ladies and gents.
Yup, fer shure. :-)))))
Overbilling the feds – a familiar theme these days, eh? Was the current “Mister Speakah” advising Baldacci’s accounting crew in those days or were they sloppy enough on their own?
The failed Baldacci administration will go down as the worst bunch of incompetent political hacks in the history of Maine.
Looks to me like the Potty crew is pushing hard for the title.
Not even close. The failed Baldacci administration set a standard for ineptitude that will never be equaled.
– “lost” hundreds of millions at DHHS
– The wasted $80,000,000 on the failed Mainecare billing system
– The sale of the state liquor business to connected Dem insiders at a fire sale price.
– Paul Violette and Dale McCormick stealing us blind while Baldacci WAS blind.
– Connected state employees buying state assets in no bid deals
– The epic fail that was Dirigo health
I could go on, but why bother.
Actually, it was the Baldacci-crats who got audited several times by GAO and ordered to restore monies from the Migrant Worker Education fund…a major national scandal that was hushed up by the Maine Media. They stretched the definition of eligibility to cover Portland’s illegal immigrants.
The result is the Feds. are given any requests from Maine extra scrutiny. I’m surprised they haven’t filed criminal charges against Baldacci era bureaucrats and those consultants who operated out of the Maine Dept. of Education hustling grant money they later billed local school districts for as service providers.
Read the verdict here:
Investigative Reports from the Office of Inspector General
www2.ed.gov/about/offices/list/oig/ireports.htmlPittsburgh, PA., June 17, 2009; Maine Department of Education to Pay United States $1.5 Million to Settle False Claims Involving Migrant Education Program.
sounds like they really need to fire the entire DHHS and hire some people who know what they are doing. People complain about the people who get these benefits wasting the food stamps and money they get from the state. Maybe its time to start holding DHHS accountable for the blunders ther are making. Take the money out of the social workers paycheck. they are the one makeing the mistakes.
I agree! The payback should come out of their DHHS pockets NOT those of us that didn’t have the services!
I doubt that it’s “the social workers” who are to blame. Look higher up than that.
What no its lepage faults comments yet
Oh great, so they over paid people for foodstamps now mainecare? So now these members are going to have to suffer cuts in what little assistance they get because DHHS needs to learn how to punch numbers into a computer. Seriously, are these people this incompetent? How do you make a 9.2 million dollar “Oops!”. Its amazingly frustrating. Get people in there that know what they’re doing.
Obviously if the mistakes were made in 2005-2009 this wasn’t the current administration.
Lets not let facts and dates get in the way. It has to be the Republicans and Le Pages fault. Case closed what can we blame on them next?
I am perfectly willing to blame the things on them that belong to them. This is not one of them.
While he got alot of family members. Maybe get the Turnpike Authority to pay it back. oop he in jail.
So Call the OBAMA White House and order them to restore money to cover these slight overpayments. Obie is prez. and besides it was the mess from the Baldacci/Dem era which needs to be cleaned up
Well the previous Maine DHHS commissioner Brenda Harvey did a FABULOUS job.. NOT.
Oh my, this erroneous billing happened during the time period from 2005 to 2009……this may throw a wrench into the practice of blaming the current LePage administration…..Crazy…..
I hear you, but GW will be next in the blame game…LOL
2005 to 2009 was the reign of Bush and his corrupt Cronies. The loss of this money only helped the USA into the Abyss of the Bush Depression
It just keeps getting worse and worse with DHHS. Isn’t there anybody who can effectively run DHHS. It just goes on and on….twice today they have been reported for two different problems with money loss and incompetence. Why are we putting up with this incredible mismanagement. Where are our legislators in this mess and why aren’t they taking any action? Enough is enough. Now the federal govt. has had it with Maine and we are going to pay dearly. Any savings they purportedly cut and save are now going to be extended to every mistake Lepage’s administration continues to make. Please call your legislators and remember how to vote in November. Shut these incompetents down.
LePage’s tax cuts for the wealthy apparently rode on the back of serious financial accounting errors. But the Republican goal is to feed the rich and punish the poor (who they see as lazy), so they are right on track. Do they really care how it gets done?
Well, there ya go……LePage.
Baldacci. Read the Article.
I did read the article and I stand by what I said. Maybe you should read more observantly.
Read the article and it’s the Democrat’s goal to punish maine’s Poor for the screwups of the Baldacci era. …if you need help reading a calendar, just ask.
While it sounds simple, might it not be possible for the 2 DHHS’s to work-out a pro-rate on this since both had to spend a bunch of buck’s to get each others computer system’s talking to each other so neither Maine nor the Fed’s have to go thru this again ? Both DHHS’s need a simple and quick end to this so both can move on. So do the taxpayer’s.
Under the failed Baldacci administration we poured $80 million down that rat hole for a computer system that NEVER worked. Then we poured another $40 million into that cesspool at DHHS to get a computer system that barely limps along. Boy those dedicated, hard working “public servants” are really doing a great job. We should all be grateful since they’re so talented that they could all be making so much more in the private sector. [/sarcasm]
So, help me understand this. Maine overbilled the federal government for Medicaid claims, yet the hospitals are still owed millions?? How does this happen? Why aren’t people getting fired? I get that people make mistakes, even big mistakes sometimes. A 4 year screw-up on top of the foodstamp mistakes makes you wonder what else is going on. Time to stop attacking students and unions and clean some gov’t house.
Just one more example of those dedicated, hard working public employees and the stellar work they do for the state of Maine.
This is actually GW’s fault…. So don’t blame Baldy…
They are doing a swell job in Augusta….Why not turn the whole thing over to a seventh grade math class..
over billed the govt?…. maybe the extra money probably didnt go to the welfare for foodstamps etc. just saying
That seems like an excellent question to bring up. There have been enough miss-caluclations, losses, over-charging, over-billing, lost funding and lies to make one wonder just exactly what is going on over at DHHS.
So, who’s fault is this mess? Surely not the commissioner of DHHS and the governor that appointed her. Nope, it’s probably all those corrupt state employees.