Review of Medicaid Reimbursement Rates for School-Based Services in West Virginia (A-03-05-00203)

April 21, 2011 Federal auditors said the rate-setting methodology for school-based Medicaid services used by West Virginia from 2001 through 2003 was flawed, which resulted in overpayments of $22.8 million. The state’s Department of Health and Human Resources' (DHHR) Bureau for Medical Services included costs in the calculation of its rates for school-based services that were not included in the reimbursement methodology described in the approved State plan. The auditors said DHHR should have exercised better oversight of the reimbursement methodology for operating and indirect costs developed by its contractor, Public Consulting Group. Download the . . .