Audit: $17.6M in inappropriate MassHealth provider payments

Corrective actions would save an estimated $8.6 million annually

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BOSTON (AP) — State Auditor Suzanne Bump says her office has identified $17.6 million in inappropriate payments to MassHealth providers.

Bump said the audit released Wednesday looked at a one-year period and identified what she described as “unallowable, questionable, duplicative, unauthorized, or potentially fraudulent billings” at MassHealth.

MassHealth is the state’s Medicaid program.

Bump said her audit shows that the complex health care program is too susceptible to improper payments to providers.

She said there are too many provider bills that get paid even though they’re duplicative of other payments, lack supporting documentation, or violate regulations governing what is and isn’t reimbursable.

Bump estimated corrective actions would save $8.6 million annually.

In the 2016 fiscal year, MassHealth paid providers $14.8 billion to cover health care services for approximately 1.9 million low-and-moderate income individuals.


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