Federal government asks for $9.2M Maine refund

AUGUSTA, Maine (AP) — The federal government is asking Maine to refund $9.2 million because of errors in calculating claims in the state's Medicaid program.

The U.S. Department of Health and Human Services posted a report on its website Thursday saying Maine's health and human services agency did not always use the correct percentage when processing claim adjustments in the Federal Medical Assistance Program. The government said that as a result, the state incorrectly claimed nearly $9.2 million for Medicaid claim adjustments.

The federal report is based on an audit by the Inspector General's office of 637,057 claims in Maine for medical assistance to low-income and disabled people from 2005 through 2009, in which only 10 percent were found to have been processed correctly.

In a written response to the findings, the state agency agreed to work with the federal government to refund identified overpayments and to determine the proper processing and reporting of future adjustments. Messages left with agency officials weren't immediately returned.

The overpayment cited by the government is a relatively tiny piece of the overall two-year state budget of about $6 billion. Medicaid cost about $552 million in state funds in fiscal 2011.

In a separate matter, the federal government is also asking to be paid back for paying out more in the food supplement program known as food stamps between April and August 2011. The Bangor Daily News said recipients will have to repay up to $80 per household through smaller future benefits.

The overpayments were made after the federal government reduced a portion of benefits in the Supplemental Nutrition Assistance Program, or SNAP, that helps recipients pay their utility bills. SNAP is also known as the food stamp program. The benefits had been temporarily increased when oil prices rose last year.

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FRANK EARLEY's picture

My favorite state agency......

D.H.H.S., The name has changed, but their quality of work and attention to detail has remained the same since I first started hating them in nineteen eighty four. They have always made mistakes, and they have always weaseled their way out of them. The ones they couldn't talk their way out of, would just have the facts changed in their rule book to correct the problem. There is no accountability in that department, in any other business, when the company makes a major mistake their responsible for it. With the combined totals for these latest acts of stupidity, people would lose their jobs. Not with DHHS.
Instead, their going after the people least likely to be able to pay, not to mention fight this ridicules decision. After all the DHHS, only made the mistakes they shouldn't be held responsible for them too.
Hey DHHS, you screwed up, you pay for it. Don't start screaming about how the state can't afford it, They can afford to pay a lot of people who don't know what the hell their doing, maybe we could start there.......

Mike Lachance's picture

Excuse me, Maine doesnt have that Money....

The recipients have the money. Get it from them. This is political cover for the Obama Admin. The money went to recipients and thats who it should be collected from.

Boy, thatd really tick off alot of folks depending on Obama to pay their mortgage, buy their gas and give them cash for tatoos and smokes.

JOHN PAINTER's picture

In neither of these cases

In neither of these cases were beneficiaries of MaineCare or SNAP programs doing anything wrong, I dont see any cover for the Obama administration, it had nothing to do with either of these blunders. In these two instances the mistakes were made in Maine, and EBT card holders who received too much will pay it back by withholdings in their monthly allotments of SNAP.

In terms of MaineCare over billing, it was the state over charging the feds by ammending bills (legitimately, e.g. a service was cost settled) for health care services which were delivered at a time when the federal match was relatively low, but when they rebelled the service billed at the higher enhanced rate when they resubmitted, not the lower rate of when the health services were actually delivered.

This is the link to the OIG finding and Commissioner Mayhews response, both are serious but cordial.

What's concerning is that the Commissiner hints in her response that she expects there are other problems and repayments likely after the date range of this one audit "due to the current configuration of the claims system that for the time period beyond the audit period covered there will be a reduction in any amount due to CMS". I hope the Commissiner continues to show appropriate leadership resolving these problems she inherited.


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