Review of Central Louisiana State Hospitalís Hurricane-Related Uncompensated Care Claims
Louisiana did not always claim reimbursement for services provided by Central Louisiana State Hospital (the Hospital) in accordance with Federal and State laws and regulations or with the approved provisions of the uncompensated care pool (UCCP) plan. In response to Hurricane Katrina, the Deficit Reduction Act of 2005 authorized Federal funding for the total costs of medically necessary uncompensated care furnished to evacuees and affected individuals without other coverage in eligible States. CMS approved Louisianaís UCCP plan to reimburse providers for medically necessary services provided to Hurricane Katrina evacuees and affected individuals and to Hurricane Rita evacuees without other coverage.
Of the $3.7 million in costs claimed for services provided to 86 patients, $3.4 million was unallowable. Louisiana claimed the unallowable costs because it (1) did not have procedures to ensure that it claimed uncompensated care costs only for services covered under the Medicaid plan; (2) relied on the Hospital to verify that the costs claimed were based on actual inpatient days; (3) did not offset its uncompensated care claim by payments received from other sources on behalf of the patients; and (4) did not have procedures to verify that patients whose costs were claimed under the Hurricane Rita UCCP were, in fact, evacuees.
We recommended that Louisiana refund to CMS the $3.4 million in unallowable costs claimed. Because the Stateís authorization to obtain Federal reimbursement for hurricane-related uncompensated care has ended, we made no procedural recommendations. The State disagreed with our findings and recommendation. Nothing in the Stateís comments caused us to revise our findings or recommendation.
Filed under: Centers for Medicare and Medicaid Services