Sunday, February 17, 2013

Federal Audit Finds $5 Million In Indiana Mental Health Medicaid Fraud


If there are questions surrounding the validity of Medicaid billing for psychiatric services for adults, you can bet your bottom dollar there are bigger questions of cost reimbursement legitimacy with children's psychiatric services.

Unfortunately, no one wants to look into Medicaid fraud in child welfare but me.

The State agency claimed $5,841,815 in Federal reimbursement for Medicaid inpatient psychiatric service payments made to Logansport that were not in accordance with Federal requirements for inpatient psychiatric hospital services. Logansport did not demonstrate compliance with the special Medicare CoP at any time during the audit period. Therefore, all of the $5,841,815 in such Federal reimbursement for claims with dates of service during the audit period was not allowable. The State agency made these improper claims because it believed that Logansport had met all requirements to be eligible for Medicaid inpatient psychiatric service payments. 

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