March 20, 2019 Comprehensive audit of health department shows minor findingsOnly financial overpayment is for $8,112

Baton Rouge, Louisiana, Mar 20, 2019 - In its most recent comprehensive audit of the management and finances of the Louisiana Department of Health and its Medicaid program, the Legislative Auditor identified nine findings. The findings included process and record keeping errors and a single overpayment of $8,112 to home and community-based providers because services were not properly documented.

Dr. Rebekah Gee, secretary of the Department of Health, said nine audit findings are too many and are being corrected. She added that the Department has a goal of zero audit findings in the future.

“For the largest state agency that is responsible for billions of taxpayer dollars, it is good news that the only overpayment identified by the auditor was for $8,112 out of the $460 million waiver program that provides an array of services to assist people with disabilities to live in the community,” Gee said. “I am pleased that the findings did not identify any areas in which patient care or safety was compromised.”

Several of the items listed in the audit addressed reporting errors, with no financial impact, all of which have been corrected. These include:

• Failure to include required third-party liability language in an electronic Medicaid application record.
• Incorrect cost allocation for charges related to the state audits of federal programs administered by the Department. 
• Inaccurate reporting of federal grant amounts that LDH paid to subcontractors. 
• Submitting a federal report with information on the wrong lines for the reporting of emergency medical services. 

Other findings include:

• Provider enrollment: Failure to enroll with the State all providers who participate in the Department’s managed care program. It is important to note that these providers all met the enrollment qualifications for the managed care plans in which they participated.
• WIC program: Failure to follow a process to review redeemed food vouchers according to the Department’s review timeline. The Department has established USDA-approved limits in place and there is Contractor in place who routinely reviews food voucher redemption amounts to assure they do not exceed the maximum allowable purchase amounts. However, the Department will institute an additional routine review of the Contractor’s reports to strengthen the program’s ability to detect and prevent fraud. 
• Provider revalidation: The auditor cited the Department for failing to conduct revalidation screening for ownership and licensing of providers every five years. While complete revalidations were not conducted, LDH does conduct monthly checks for excluded providers and proactively excludes providers from Medicaid for fraud, waste and abuse concerns.  

Medicaid eligibility: An additional finding was a repeat of an audit issued in 2018 that concluded Medicaid’s eligibility system was inadequate. This old, antiquated system was recently replaced by a modernized system that can make more accurate eligibility determinations.