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Home Health & Hospice Week

Industry Note:

Medicaid Audit Programs Hemorrhaging Money, GAO Says

Published on Fri Dec 14, 2012

Medicaid is paying twice for audit activities, according to a GAO report released on Dec. 10. The Medicaid Integrity Group has been hiring separate review and audit contractors for its National Medicaid Audit Program, causing serious inefficiencies and duplicate efforts -- not to mention double the costs. "Review contractors analyze state claims data to identify aberrant claims or billing anomalies, while audit contractors conduct post-payment audits to determine if payments to providers were improper," the GAO states. These functions are far too similar, and the "poor coordination and communication" among the two camps yielded duplicative data analysis and inefficiencies -- leading to lengthy audit timeframes. The average audit took nearly two years to complete. You can view the GAO report at www.gao.gov/products/GAO-13-50.
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