The agency overseeing treatment for Marylanders with developmental disabilities lost $4.1 million in federal money over two years, according to an audit by the General Assembly.
“Available federal funds … were not claimed during calendar years 2004 and 2005 because the service rates used to request federal reimbursement had not been increased to correspond with the rates paid to providers,” states the report?s introduction by auditor Bruce A. Myers.
Of that money, more than $800,000 can never be recovered by the Developmental Disabilities Administration because it is more than two years old, the audit states.
The audit also found claims initially rejected by the federal government were not aggressively challenged, Medicaid-eligible clients were not identified and enrolled in the health care program, and internal efforts to ensure providers accurately billed the system were not completed within the legal time frame.
The DDA is adequately staffed to address Maryland?s disabled residents and the issues identified in the audit, said Karen Black, spokeswoman for the Maryland Department of Health and Mental Hygiene.
“The DDA has resolved most of the issues in the audit,” Black said.
The department agreed with most of the auditors? findings and said steps were being taken to address the shortcomings.
“The administration has reviewed all claims submitted for reimbursement in lower amounts and to the extent possible will resubmit the claims … by the end ofthe calendar year,” Health Secretary John M. Colmers wrote in his response.
The administration contested the finding that all eligible Medicaid recipients were not identified and enrolled in the federal program.
“DDA does have a robust system in the regions for tracking whether initial Medicaid applications are submitted,” it said. “Also, DDA forwards monthly reports to service coordinators showing which [reviews of eligibility] are due.”
Those receiving “low-level services” would cost more to manage than federal reimbursement would provide, the response also states.
Maryland?s providers are entitled to reimbursement for up to 9,988 clients, but as of Dec. 31, 2005, the state had only 9,877 clients enrolled, the audit found. Another 2,673 clients were not in the federal program but received Medicaid-reimbursable services. Of those, 785 had not been denied Medicaid coverage.
Annual care for DDA clients ranges from $1,350 to more than $60,000.
Audit findings
» DDA did not aggressively pursue federal reimbursement through Medicaid
» DDA did not ensure providers gave the services they billed for
» DDA did not track money aimed at improving salaries of care providers or recover improperly used funds.
» Waiting-list records were not always accurate
» DDA did not verify community living arrangements were properly billed
» DDA did not adequately secure recipient database
Source: Executive summary, DDA audit
