Waste, Fraud & Mismanagement:
Your Tax Dollars at Work

State Overpaid $1.2 Million for Wheelchairs, Auditor Says. The Department of Health Care Services paid about 25 percent more than it should have in Medi-Cal claims for durable medical equipment (such as wheelchairs and wheelchair accessories) during a recent audit period, the California State Auditor reported June 17.

The auditor noted that while the department has recovered almost $960,000 of the $1.2 million in overpayments, "it does not know the extent to which other providers may have also overbilled for medical equipment." The auditor pointed out that the $1.2 million in overpayments was discovered after "a limited review of providers" conducted by the department, so there is a likelihood that many more overpayments went through.

"Current auditing efforts do not provide enough coverage of medical equipment reimbursements to effectively ensure providers' compliance with the billing procedures," the auditor stated.

The audit also found that because the Department of Health Care Services "has not identified a practical means to monitor and enforce its billing and reimbursement procedures, price controls enacted in 2003 have not met their intended purpose." (Source: California State Auditor Report 2007-122, June 17.)

Cal-Taxletter June 20, 2008

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