BATON ROUGE, La. (WDSU) — The Louisiana Legislative Auditor found more than 300 mental health providers overbilled the state’s Medicaid program at least $293,0808 for services provided in excess of 12 hours.
The report was issued Monday morning.
State law prohibits providers from billing Medicaid for more than 12 hours of services in a day.
Individual behavioral health providers are required to bill their services through a business the Louisiana Department of Health has licensed. Although the business that employ them are not required to ensure individual providers do not bill more than 12 hours a day, the auditor said it is reasonable to expect the business to act as an additional layer of review to encourage compliance with state law and help prevent overbilling.
The audit identified 1,364 instances where 128 businesses allowed providers to bill more than 12 hours of services in a single day. Forty individual providers were identified who billed more than 12 hours a day for 148 days between Aug. 1, 2019, and March 2, 2020.
The auditor said the services providers billed were split among multiple businesses so they did not charge more than 12 hours through one business on the days in question.
According to the Louisiana Legislative Auditor, the businesses would not necessarily be aware when individual providers were billing more than 12 hours of services in a single day.
The auditor issued three recommendations to the Louisiana Department of Health to correct the overbilling.
To review the audit, click here.
By: WDSU Digital Team