OIG’s $38.2 billion in savings and expected recoveries encompasses $35.8 billion in implemented recommendations and other actions to put funds to better use, $789.4 million in audit receivables, and $1.6 billion in investigative receivables.
Interesting items in the report include:
(1) Review of emergency preparedness in Gulf Coast nursing facilities post-hurricanes, yielding the conclusion that the regulations, not the regulated community, need some work; and
(2) Closer to home here in Boston:
OIG identified $87 million in Federal Medicaid overpayments for targeted case management services in Massachusetts. Medicaid pays for targeted case management services to assess Medicaid beneficiaries’ service needs, refer beneficiaries to needed services, and monitor the services. It does not pay for direct social services to which beneficiaries have been referred. However, the State included the costs for direct social services in the rates used to claim reimbursement for targeted case management services. OIG recommended that the State refund the resulting $87 million overpayment.
To quote an old TV cop: "Be careful out there."
— David Harlow