Minnesota State Audit Shows Medicaid HMOs Overpaid By $162 Million Between 2003 & 2011

From 2003 through 2011, Minnesota Medicaid overpaid its four health maintenance organization contractors by $162 million. For the eight-year period under review, HMOs had profit margins of 3.1%, although the state rate setting calculations had projected a profit margin of 1.0%. The HMO contractors include UCare; HealthPartners, Inc.; MHP; and BlueCross Blue Shield of Minnesota (BCBSMN). The overpayment was reported by the Minnesota Department of Human Services (DHS) on March 1, 2013, in a presentation to the legislature about the findings of a retroactive review of managed care rate setting conducted by the Segal Company. DHS released . . .