Skip to main content
Report File
Date Issued
Submitting OIG
Department of Health & Human Services OIG
Other Participating OIGs
Department of Health & Human Services OIG
Agencies Reviewed/Investigated
Department of Health & Human Services
Report Number
A-06-16-02003
Report Description

Louisiana did not comply with Federal and State requirements prohibiting Medicaid payments for inpatient hospital services related to treating certain provider-preventable conditions (PPCs) because it did not have controls to identify claims with PPCs that would have required a reduction in claim payment. We identified inpatient hospital claims totaling $55.4 million ($34.9 million Federal share) that contained a diagnosis code identified as a PPC and certain present-on-admission (POA) codes, or the claims were missing POA codes.

Report Type
Audit
Agency Wide
Yes
Additional Details
https://oig.hhs.gov/oas/reports/region6/61602003.asp

Open Recommendations

This report has 1 open recommendations.
Recommendation Number Significant Recommendation Recommended Questioned Costs Recommended Funds for Better Use Additional Details
266121 No $0 $0

We recommend that the State agency review all claims with dates of admission before our audit period (from July 1, 2012, and paid through December 31, 2012), and all claims paid after our audit period (June 30, 2017), to determine whether payments should be reduced for any claims that contained PPCs and refund to the Federal Government its share of any unallowable amounts.

Department of Health & Human Services OIG

United States