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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-07-15-04219
Report Description

With respect to Medicaid patient days, Wisconsin Physicians Service (WPS) did not properly settle Medicare cost reports submitted by Indiana hospitals for Medicare disproportionate share hospital (DSH) payments in accordance with Federal requirements. The 48 selected providers improperly claimed a total of 14,325 Medicaid patient days on their Medicare cost reports, resulting in DSH overpayments totaling $6.1 million. These improper claims included both unallowable and unsupported patient days and involved separate Child Health Insurance Program (S-CHIP) recipients, Aid to Residents in County Homes (ARCH) recipients, 590 Program recipients, and dual eligibles.

Report Type
Audit
Location

WI
United States

Number of Recommendations
3
Questioned Costs
$6,110,557
Funds for Better Use
$0
External Entity
Wisconsin Physicians Service Insurance Corporation

Department of Health & Human Services OIG

United States