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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
Department of Veterans Affairs
Review of the Replacement of the Denver Medical Center, Eastern Colorado Health Care System
Illinois improperly claimed $149,000 in Federal Medicaid reimbursement over a 2-year period for inpatient hospital services related to treating certain provider-preventable conditions. In addition, Illinois improperly reduced Federal Medicaid reimbursement by $52,000 for inpatient hospital services that did not relate to treating provider-preventable conditions
Although the Washington State Health Care Authority (State agency) made Medicaid electronic health record (EHR) incentive program payments to eligible hospitals, it did not always make these payments in accordance with Federal requirements. Specifically, from October 1, 2011, through December 31, 2015, the State agency made incorrect Medicaid EHR incentive payments to 19 of the 20 hospitals reviewed, totaling $11.3 million. These incorrect payments included both overpayments and underpayments, resulting in a net overpayment of $9.2 million. Because the incentive payment is calculated once and then paid out over 4 years, payments made after December 31, 2015, will also be incorrect. The adjustments to these payments total $2.5 million.
