MADISON, Wis. (AP) — A federal audit due out Friday found that Wisconsin health officials failed to provide adequate justification for $22.8 million in Medicaid charges and recommends trying to reclaim that money from the state.
The Wisconsin State Journal reported (http://bit.ly/16uc5OP) that the charges cited in the U.S. Department of Health and Human Services review pertain to services at 27 residential care centers that provide mental health care for young people from October 2004 through September 2006 . Democrat Jim Doyle was governor during those years.
Kitty Rhoades, the current Wisconsin Department of Health Services secretary, wrote a rebuttal in May in which she said the auditors misinterpreted and misapplied their own laws and rules. She said the charges are based on the notion that treatment provided in the centers went on throughout each day and wasn’t limited to group or individual counseling sessions.
But the audit found that the state’s cost estimates weren’t supported by adequate studies and documentation about how much time was actually spent in treatment. The review also alleges the state tacked on an improper charge to support the centers’ operating costs.
The state began dramatically increasing its billings in 2005 after an unnamed consultant recommended changing its formula to boost federal reimbursements, the audit said.
“The state agency relied on its consultant’s advice in determining the percentage of (center) salary costs to allocate to the Medicaid program without validating whether the estimates the consultant used were reasonable and relevant to (the centers),” the audit said.
Rhoades said including staff salaries in the Medicaid charges was reasonable since they help young people with severe emotional problems around the clock.