Louisiana’s health department is sloppy in monitoring billions of dollars in payments to private companies that manage care for 1.5 million of the state’s Medicaid patients, according to a new audit, The Associated Press reports.
Legislative Auditor Daryl Purpera’s office identified what it considers a lengthy list of shortcomings in the oversight of the five managed care organizations from 2012 through 2017.
Auditors say the Louisiana Department of Health isn’t properly tracking health providers billing the managed care organizations for Medicaid patient services. The report says that lax oversight makes it impossible to know if the Medicaid program is paying for things it shouldn’t be.
“Without complete data that accurately identifies the provider who performed the service, who was paid for the service, where the service was provided and the level of services the provider is allowed to perform, LDH cannot effectively monitor the (companies) and decrease the risk of improper payments,” auditors wrote in the report.
Health department officials said Tuesday that the audit is misleading. Michael Boutte, Medicaid deputy director, said the agency has many ways to track provider claims that auditors didn’t review.
The review said auditors found 41 million paid claims totaling $2.4 billion from October 2015 through December 2017 that didn’t have valid provider identification numbers.
