AUGUSTA, Maine (AP) — The federal government is asking Maine to refund $9.2 million because of errors in calculating claims in the state's Medicaid program.
The U.S. Department of Health and Human Services posted a report on its website Thursday saying Maine's health and human services agency did not always use the correct percentage when processing claim adjustments in the Federal Medical Assistance Program. The government said that as a result, the state incorrectly claimed nearly $9.2 million for Medicaid claim adjustments.
The federal report is based on an audit by the Inspector General's office of 637,057 claims in Maine for medical assistance to low-income and disabled people from 2005 through 2009, in which only 10 percent were found to have been processed correctly.
In a written response to the findings, the state agency agreed to work with the federal government to refund identified overpayments and to determine the proper processing and reporting of future adjustments.
The director of the office of MaineCare Services, Stefanie Nadeau, said the errors resulted from a "perfect storm" of events between 2005 and 2009.
During that period, the federal government significantly increased Medicaid matching rates as part of the federal economic stimulus act. That period was also marked by a failure in the state's claims processing system, which was not fixed until 2008, said Nadeau. That computer failure, in turn, created a backlog of claims adjustments that had to be addressed in the department, she said.
The overpayment cited by the government is a relatively tiny piece of the overall two-year state budget of about $6 billion. Medicaid cost about $552 million in state funds in fiscal 2011.
In a separate matter, the federal government is also asking to be paid back for paying out more in the food supplement program known as food stamps between April and August 2011. The Bangor Daily News (http://bit.ly/NXMHLx ) said recipients will have to repay up to $80 per household through smaller future benefits.
The overpayments were made after the federal government reduced a portion of benefits in the Supplemental Nutrition Assistance Program, or SNAP, that helps recipients pay their utility bills. SNAP is also known as the food stamp program. The benefits had been temporarily increased when oil prices rose last year.