Au­dit finds MassHealth made $93 mil­lion in im­proper pay­ments

Modern Healthcare - - REGIONAL NEWS - —Maria Castel­lucci

MassHealth, Mas­sachusetts’ Med­i­caid pro­gram, made about $93 mil­lion in im­proper pay­ments for be­hav­ioral health ser­vices over five years.

An au­dit re­leased last week and con­ducted by State Au­di­tor Suzanne Bump found that from July 2010 to June 2015, the state failed to bill the Mas­sachusetts Be­hav­ioral Health Part­ner­ship, a man­aged-care or­ga­ni­za­tion that pro­vides ser­vices to Med­i­caid pa­tients. The report also rec­om­mended that MassHealth re­view about $100 mil­lion in claims.

The part­ner­ship serves more than 375,000 of MassHealth’s 1.9 mil­lion ben­e­fi­cia­ries. In to­tal, MassHealth paid about $2.6 bil­lion for mem­bers who are en­rolled in the Mas­sachusetts Be­hav­ioral Health Part­ner­ship.

The au­dit found billing mis­takes due to im­proper cod­ing and du­plica­tive pay­ments.

A MassHealth spokesper­son dis­agreed with the au­dit, which the agency claims mis­tak­enly in­cludes items such as flu shots as be­hav­ioral health ser­vices cov­ered by Mas­sachusetts Be­hav­ioral Health Part­ner­ship be­cause the pa­tient is an en­rollee.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.