Report: OHA Still Has Work To Do Improving Medicaid Payment Oversight
A follow-up report released Wednesday by the Oregon secretary of state's office says the Oregon Health Authority (OHA) has addressed some issues related to improper Medicaid payments, but there's still more work to be done.
In a November 2017 audit, the secretary of state's office made eight recommendations to OHA to improve efforts to detect and prevent improper Medicaid payments.
That audit found more than 31,000 questionable payments based on 15 months of data.
The follow-up report stated OHA has only fully implemented two of those recommendations. It has partially implemented the remaining six.
So far, OHA has started a process to identify people who need their Medicaid eligibility redetermined. It also developed new Coordinated Care Organization contracts to improve oversight.
The agency is still facing a backlog in processing Medicaid applications, the report states, and will be hiring additional staff to address that.
"We are encouraged by the progress OHA has made to implement the audit’s recommendations,” said acting Secretary of State Leslie Cummings in a press release. “But there is still more work to be done to ensure Oregon improves its efforts to prevent and detect improper payments within the Medicaid program.”
The report says even when all of the recommendations are implemented, OHA will require ongoing work as the Medicaid program continues to evolve.
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