Audit finds MassHealth made $93 million in improper payments
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.