Blanco Individual Health Insurance

Audit finds millions in improper payments by Louisiana for Medicaid providers

The review showed the improper payments risings over the six-year period that spanned the administrations of Govs. Kathleen Blanco and Bobby Jindal. In fiscal 2005, the amount was $161,638. The annual figure peaked at $1.66 million in fiscal 2010. The audit reviewed billing activity in three service areas: the Long-Term Personal Care Services Program; the Elderly and Disabled adults waiver program; and the New Opportunities waiver program.

Auditors attributed the errors primarily to an inadequate system of tracking services and scrutinizing claims submitted by Medicaid vendors. The report also criticized the Department of Health and Hospitals for not doing a better job of screening providers and noted that the agency's process for certifying Medicaid vendors is not yet in compliance with new standards set by the 2010 federal health insurance overhaul.

Blocking "low-quality providers" from the Medicaid program, auditors wrote, "is one of the strongest methods to prevent improper payments."

In a written response to the audit, the Department of Health Hospitals disputed none of the findings and endorsed 17 changes in policies and procedures recommended by the auditors. Jerry Phillips, the state Medicaid chief, noted that some of the recommendations already are in place or will be soon, including more intensive electronic verification of site visits for in-home care under a recently awarded contract for a new Medicaid management information system.

DHH also reported issuing fines with more frequency since the time frame included in the audit and said it has begun to change its process for certifying Medicaid vendors. The programs in question involve more than 47,000 direct-care workers.

Among the specific findings:

In calendar 2010, 1,563 direct-care providers drew between $700,000 and $1.3 million in potentially improper payments for service times that overlapped between different patients on the same day.

Since 2003, providers collected more than $780,000 for in-home services billed for times when the patient was in a hospital, nursing home or adult day health-care center.

From the Porch at Oak Crest - Johnson City Record Courier ...

Okay folks; get ready for the Johnson City Health Fair sponsored by Texas Home Health and Combined Community Action. This will be held on September 30th, 2011 from 9:00 am to noon @ the First United Methodist Church on105 LBJ Drive, Johnson City, TX 78636.

Air Evac Lifeteam, Area Agency on Aging-help with form for, SS, SSI, Medicare, etc., Blanco County Red Cross, Blanco Senior Center, Catholic Charities-help with forms for SSI, SS, etc., Capitol Area Food Bank—will help with Food Stamp Forms, CARTS-transportation, Combined Community Action-Meals on Wheels, City of Johnson City-Recycling Center, Community Action, Inc. - Self Sufficiency Specialist, Fredericksburg Medical Equipment, HEB – from Marble Falls with Flu and Pneumonia shots, Henry House Assisted Living—Blanco, Hill Country Center - Transportation for Cancer Patients, Johnson City Housing Authority-low income housing, Johnson City Volunteer Fire Department, LBJ Nursing Home, Live Oak Medical Center—Blanco, National Hearing Center, North Blanco EMS, Patients Choice, PEC – providing member information plus they do presentations for clubs, schools etc., Providevida Care DMV, Strickland’s Drug Store—free delivery to JC, Texas Home Health & Hospice, Windcrest Nursing and Rehab.

For VENDORS interested in joining, please call Nancy @ 830-265-7724 to get a FREE spot to set up.

There will be FLU Shots and Pneumonia Shots. Bring your Medicare Care or Insurance Card. There will be Door Prizes! There will be brochures posted around town. Pick one up so that you have a reminder to attend…see you there… and REMEMBER DOOR PRIZES…. Watch right here for more vendors next week and updates.

We had a great 3rd Friday Luncheon and we had mostly Italian food and lots of great desserts. Bingo was great and Wilma won the handmade Afghan. It was really beautiful. We thank Betty Simon for her wonderful work and for her donation each month. Betty, you make Bingo exciting.

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