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Audits of Medicaid Service Providers Protect Seniors, People with Disabilities, Taxpayers

By PA Auditor General

Jun 24, 2020
PA Auditor General

First round of audits finds room for improvement; $19,000 in discrepancies

HARRISBURG – Auditor General Eugene DePasquale said new audits of Medicaid service providers that receive billions of taxpayer dollars each year prove the value of additional oversight.

“We must ensure that Medicaid patients receive the services for which the state is billed by direct care providers, and taxpayers have a right to know the money invested is used effectively and efficiently,” DePasquale said. “These audits show that for the most part the system is working, but there is always room for improvement.”

The first round of special financial-related performance audits were authorized under Act 42 of 2018, which was spearheaded by Senate Appropriations Committee Chairman Pat Browne and received bipartisan support in the General Assembly. The vendors provide a variety of medical and human services, including long-term care and mental health services.

“All five audits include recommendations to enhance their checks and balances to ensure that every single Medicaid dollar goes to help seniors and people with intellectual disabilities,” DePasquale said. “My team will continue conducting similar audits to provide another layer of oversight.”

Three of the audits included financial-related findings that were referred to the state Department of Human Services (DHS):

o   Inadequate management controls allowed the Barber National Institute to submit a Medical Assistance claim for duplicate services, resulting in an $18 overpayment.

o   Masonic Village of Elizabethtown failed to comply with a state regulation when it prematurely submitted two valid Medical Assistance claims, totaling $19,085, for reimbursement.

o   PATH (People Acting To Help) Inc. did not comply with the Department of Human Services’ policy regarding content of service notes and received $89 in overpayments for services not rendered.

Learn more about the Department of the Auditor General online at www.PaAuditor.gov.

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