Medicaid DSH Audit Update held April 2

Posted on: 4/09/2014

Erik Grimes and Lamont McKenzie from Myers and Stauffer, LC gave a presentation at OHA April 2 on their firm’s audit of the Oklahoma Medicaid Disproportionate Share Hospital (DSH) payments for the 2011 DSH year, October 2010 through September 2011.

Myers and Stauffer are requiring Disproportionate Share Hospitals to submit information for the 2011 DSH payment year in a survey and exhibit format very similar to the format they used for the 2010 DSH audit. Hospitals that received Medicaid DSH payments for 2011 should have received an audit information request from Myers and Stauffer recently. Information is due May 2, 2014.

The 2011 year being audited is the first year that DSH payments are subject to recoupment.

Totals of covered days, charges and payments for inpatients and outpatients will be provided to hospitals for SoonerCare claims and Medicare crossover (to SoonerCare) claims. The payment information will include Medicare payments for crossover claims and third party liability (TPL) payments, as well as Medicaid payments. By mid-April, this information is to be provided by the Oklahoma Health Care Authority to Myers and Stauffer, who will forward it to the hospitals. Hospitals will need to break out the applicable days and charges by cost center using information from hospital records. 

The presentation included discussion of a few changes in data requirements for 2011 from 2010, and of some of the significant data issues identified in the 2010 audit.

The presentation slides are available on OHA’s Medicaid page, www.okoha.com/Medicaid. The auditors’ contact information is listed on the last slide.

An online recording of the 90-minute presentation is available from OHA for $50. Unfortunately, the sound for the first five or six minutes of the presentation is inaudible. Contact Shelly Bush at OHA, [email protected], for more information on the recording.  (Rick Snyder)