Federal audit forces New Hampshire to repay $7.9M Medicaid funds

MM Curator summary

[MM Curator Summary]: NH is writing a check to CMS over issues with poor quality of opioid addiction treatment services- 90% of methadone clinics did not provide required followups and other care.


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(The Center Square) – A majority of Medicaid-funded treatments for New Hampshire opioid addicts don’t meet quality standards, according to a new audit, which will require the state to pay back nearly $8 million to the federal government.

The audit, conducted for the U.S. Department of Health and Human Services, found that more than 90% of the state’s methadone treatment programs that billed the Medicaid program for services didn’t provide the required follow-up counseling or long-term recovery plans, and in many cases didn’t require follow-up with tests for illegal drugs.

Of 100 opioid treatment cases reviewed by federal auditors, only six complied with state and federal laws, according to the report.

“These deficiencies occurred because New Hampshire did not have the resources to oversee providers and enforce the opioid treatment program requirements,” the auditors wrote in the report. “Providers said high personnel turnover, difficulty attracting and retaining personnel, and difficulty keeping patients engaged in counseling services contributed to the lack of adherence to state requirements.

Auditors also pointed out the New Hampshire officials didn’t provide enough guidance to providers on the treatment requirements.

In a response to the audit, New Hampshire officials accepted the findings and agreed to refund $7.94 million to the federal agency. That amount covers the estimated cost for more than 350,000 Medicaid claims from 2016 to 2019, according to the audit.

Overall, state officials say drug treatment programs have suffered the same staffing shortages in personnel as other health-care sectors which has impacted care.

“New Hampshire is not unique in the difficulty health-care providers experience recruiting and retaining direct workforce,” Henry Lipman, director of the state’s Medicaid program, wrote to HHS in a response to the audit.

He said the state is working on plans to expand the health care workforce and last year convened a working group of stakeholders to work on solutions to the hiring crunch.

“Over 70 health-care thought leaders from around the state convened to identify aligned priority projects and strategies that the department is uniquely positioned to help collaboratively address,” Lipman wrote. “We believe these efforts are important to ensuring care is delivered timely and with appropriate documentation.”

He wrote that the state has ordered Medicaid funded opioid treatment providers to conduct reviews of their programs and submit their findings next month.

But Lipman disagreed with claims in the audit that opioid treatment services are being rendered by “clinically unqualified personnel.”

“We are committed to working with OTP providers and Managed Care Organizations to ensure OTPs are available to provide critical treatment services which meet New Hampshire’s high standards of care,” he wrote in his response.


Clipped from: https://www.washingtonexaminer.com/news/audit-forces-new-hampshire-to-repay-medicaid-funds