Texas Did Not Appropriately Spend Some State Balancing Incentive Payments Program Funds

The Texas Health and Human Services Commission (State agency) did not always calculate supplemental payments made to the Texas Tech University (TTU) health institutions in accordance with Federal and State requirements. Specifically, the supplemental payment calculations included overstated Medicare equivalent fees for claims that included payment modifiers and diagnostic test modifiers, Medicaid services that were performed by ineligible providers, and Medicaid services that did not have Medicare equivalent fees. As a result, the TTU health institutions received $9.9 million (Federal share) in unallowable supplemental payments for the period May 1, 2004, through September 30, 2007.