The Louisiana Legislative Auditor published a report this morning citing issues with the Louisiana Department of Health, which it accuses of repeating some of the same problems from past years.
Of the fourteen findings outlined in the audit, seven were also noted last year and multiple issues were cited for several consecutive years.
LDH paid $4.8 billion to Healthy Louisiana managed care organizations without first receiving required contract amendment approvals, and also made some $868 million in payments for service dates outside the certification period.
For the second consecutive year, LDH did not enroll and screen Healthy Louisiana managed care providers and dental managed care providers by deadline, as required by federal regulations.
For the second year in a row, the department didn’t have adequate controls over Medicaid and LaCHIP eligibility determinations and did not use federal tax data to verify applicants’ eligibility.
For the eighth consecutive year, the department paid several waivers that were not documented as required, and for the fifth consecutive year, LDH failed to accurately complete required quarterly reports of federal expenditures.
The audit also found LDH, the managed care organizations and Magellan Health Services did not have adequate controls in place to ensure that behavioral health services in the Medicaid program were properly billed and that improper encounters and claims were denied.
In a Medicaid Audit Unit issued last year, the auditors identified approximately $47.5 million in encounters and claims for services between December 2015 and June 2019 that were paid by the three entities even though claims did not comply with regulations.
Read the full report, or check out a two-page summary of the auditor’s findings.
