DHSS DEMANDS HEALTH CARE PROVIDERS PAY BACK
Fifteen million dollars in billing errors by the Alaska Department of Health and Social Services to health care providers resulted in overpayments during the past six months — overpayments that were easily not noticed by providers but are now being clawed back by the State.
About 1,100 medical providers will be required to return anywhere between a few dollars to hundreds of thousands of dollars apiece due to an administrative error, according to Deputy Commissioner Jon Sherwood, who oversees the Medicaid program. His department has made no formal announcement of the massive error and Commissioner Valerie Davidson is not taking a visible leadership role in managing the crisis for health care providers who are on the hook.
HOW DID THIS HAPPEN?
Last year, DHSS decided to roll back to its 2015 allowable reimbursement rates to save the State money, after Medicaid costs grew out of control.
The Medicaid program cost the State $1.7 billion plus $45 million in supplemental funds appropriated to keep the program from running out of money through the end of Fiscal Year 2018.
The rollback never happened due to an administrative oversight. The full reimbursements kept going out, and many medical providers simply assumed the rollback had not yet taken place.
The State is now demanding that medical providers pay back 10.3 percent of what Medicaid paid them between Oct. 1, 2017 and June 11, 2018.
Medical providers who contacted Must Read Alaska said they are stunned and furious that the State has shown such ineptitude in handling Medicaid payments, not discovering the error until June, long after workers have been paid and other payments have been made with the money.
“Governor Walker expands Medicaid, then cuts reimbursements by 10 percent, then fails to execute his reduction in a timely manner, so now is going back retroactively to take money back,” said one medical executive, clearly exasperated.
DHSS has made no public announcement of the situation and has yet to inform each provider what the back-due payments will be and when those payments are expected.