Posts tagged: state auditor's office
OLYMPIA — The state needs to a better job of checking its Medicaid managed care programs for cost overruns, the state auditor's office said today.
A limited audit of the Health Care Authority's system to check doctors and other specialists in eight high-risk areas showed overpayments estimated at $17.5 million in 2010. Other tests showed billing error rates for administrative costs of 8 percent and 12 percent in samples from two of the largest organizations. Those overpayments could have raised the costs to those managed care organizations, but they also could have cost the state more for higher premium rates in 2013 when the rates are calculated based on past costs.
Because the audit was limited, and there were underpayments as well as overpayments within the areas examined the auditor's office couldn't say if the net result was an overpayment in the systems as a whole. “We cannot conclude that 2013 premiums paid by the state were higher or lower than they should have been,” the audit says.
The Health Care Authority needs contracts with its managed care organizations that allow the agency to monitor data thoroughly, and to recover overpayments when they are found, auditors said. It should also give the organizations clearer guidance on the data it sends to an actuary and have a more comprehensive monitoring system.
Better controls are becoming more important, auditors said, because Medicaid coverage is expanding under federal health care reforms and most of the people being added to the system will have managed care. The audit studied services that predated the Affordable Care Act.
OLYMPIA – Add to the long list of things the Puget Sound communities have that Spokane residents can be glad they don’t: Toll bridges.
Spokane’s last such facility, the Maple Street Bridge, removed “Toll” from its title in 1990 after some 42 years of collecting spare change. For most of that time, the toll was a dime. In one of the best signs of how – shall we say thrifty? – Spokane was, many people drove a half-mile out of their way and waited through several more traffic lights to use the Monroe Street Bridge rather than toss two Tom Jeffersons or one FDR in the basket. . .
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OLYMPIA – More than 15,000 people who qualify for a program to aid the disabled are on a waiting list and receive no services because there's not enough money, a state audit of the Developmental Disability program says.
The program spends about $900 million a year on assistance to state residents with developmental disabilities, but that's not enough to cover more than 35,000 who qualify for aid, the state auditor's office said. Among its recommendations was for the Legislature to significantly increase the amount it spends on the program and develop a plan to reduce the wait list. . .
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