Audit: $4.2M in improper La. Medicaid spending for lab work
Published 8:24 pm Monday, September 11, 2017
BATON ROUGE — A new audit says Louisiana’s Medicaid program improperly paid $4.2 million for laboratory services and tests that shouldn’t have been covered.
Legislative Auditor Daryl Purpera’s office reviewed payments over five years, between July 2011, and June 2016, mainly during former Gov. Bobby Jindal’s administration. Findings were released Monday.
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The auditors said the $4.2 million was paid by the health department and private managed-care companies who administer health plans for many of Louisiana’s Medicaid recipients. The report says the department didn’t monitor the managed-care companies to ensure their lab payments are in compliance with their state contracts.
The health department says that since Gov. John Bel Edwards’ administration took office 18 months ago, it has started an automatic monitoring system for the lab payments and more regularly reviews its payment process.
"When this administration came on board, we discovered that in spite of Medicaid policy, some labs that were being used by clinics, nursing homes, hospitals and other providers did not have the proper certifications," Jen Steele, Medicaid director for the health department, said in a statement.
The department disagreed, however, that $1.7 million was improperly paid for claims with an invalid procedure code, saying the code at issue was valid at the time of the spending.