Maine discovers millions in Medicaid overpayments

Posted March 10, 2011, at 8:35 p.m.
Last modified March 11, 2011, at 8:59 a.m.

AUGUSTA, Maine — Maine Health and Human Services Commissioner Mary Mayhew says her department has discovered tens of millions of dollars in larger-than-budgeted payments to Maine hospitals and social service programs and that corrective steps are being taken.

Mayhew says a $66 million Medicaid overpayment to Maine hospitals resulted from changes in the state’s claims processing system. The overpayments from MaineCare, the state’s Medicaid program, started in September. The state is on pace to overpay the hospitals by $119 million by June 30, but Mayhew, who was vice president of the Maine Hospital Association before joining the LePage administration, says payments to hospitals will be adjusted beginning March 19 to account for the error.

In addition, MaineCare payments to service providers have jumped by approximately $10 million a week for the the past six weeks. Mayhew said analysts are trying to determine what is driving the increase. If the trend continues, MaineCare will exceed its annual budget by $30 million by the end of this fiscal year and a supplemental budget may need to be drafted.

Maine also is considering a court appeal of a recent ruling requiring the state to repay almost $30 million in disallowed targeted case management charges to the federal Centers for Medicare and Medicaid Services. The charges date back to 2002 and 2003.

In a statement issued Thursday, Gov. Paul LePage said the pricey problems being uncovered in the Department of Health and Human Services are “disturbing” but no surprise.

“We inherited a big mess, but we are going to get it fixed and find solutions that work for consumers, providers and the taxpayers,” the governor said.

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