Medicare Compliance & Reimbursement

 MI hospitals face increased scrutiny after OIG's repayment request.

Hospitals may need to brush up on their state's Medicaid regulations for graduate medical education funding.

Tighter controls are coming down the pike for teaching hospitals in Michigan after an April 15 audit by the HHS Office of Inspector General. The report, titled "Review of Michigan's Medicaid Reimbursement for Graduate Medical Education" (A-05-02-00081), identifies problems at both the state and provider level.

According to the OIG, of the 51 teaching hospitals inspected, 31 reportedly received GME funding that exceeded their operating costs by $105 million - $63 million from Medicaid.

"While these excess payments were not improper, they present an opportunity for the state to save Medicaid dollars or fund other priorities," the report reads.

Other problems included hospitals not filing reports that show how GME dollars were spent. Teaching hospitals now face annual comparisons of their Medicaid and Medicare GME revenue along with total program costs, and tighter controls on how they report expenditures of GME funding.

The Wolverine State faces a payment adjustment of $955,060 because GME funds were used for non-GME Medicaid services.