Nebraska’s Department of Health and Human Services discovered a billing problem that could cost the state up to $32 million.
At issue is a change in reimbursements to developmental disability residential service providers enacted in 2014.
A portion of existing provider billing guidelines implemented then changed what is available for federal funding participation.
“As a result of that, CMS, our federal partners, has advised that DHHS must end those unallowable payments, claiming those federal dollars, and reimburse claims already submitted back to July 1, 2014,” Courtney Miller, director of DHHS developmental disabilities division, told Nebraska Radio Network affiliate KLIN.
The department does not yet know the exact amount of claims it has to reimburse.
“DHHS expects many of the existing charges in those claims will be validated,” Miller says, “but we have to do the actual impact analysis to determine the actual amount for the fiscal impact.”
Jane Monnich, KLIN, contributed to this story.