SALEM — The Secretary Of State’s Office says the Oregon Health Authority still needs to strengthen its efforts to detect and avoid improper Medicaid payments.
The office’s audit division on Wednesday released a follow-up report to a 2017 audit that found widespread problems in the Health Authority’s payment system for Medicaid.
Auditors found that two of the eight recommendations in the audit have been put in place and six recommendations have been partially implemented.
OHA officials agreed with all of the recommendations.
The original 44-page audit, released in November 2017, found problems such as poor management of payment and eligibility issues and a lack of an agencywide process to detect improper payments.
At the time, auditors also found the agency had about $88 million in avoidable expenses because of its backlog in determining eligibility for Medicaid recipients. Medicaid provided health insurance benefits to about 1 million low-income Oregonians in 2017.
In January, Health Authority officials reported they had recovered about $42 million overpaid to organizations that coordinate Medicaid benefits.
Recommendations not yet fully put in place vary.
The new report found the Health Authority has developed systemic controls for the Medicaid Management Information System, but still lacks an adequate understanding of how they work.
The agency is taking steps to hire a contractor to test the controls’ effectiveness and report the results quarterly, the report said.
On another front, the agency hasn’t yet clarified Oregon administrative rules to hold Medicaid providers accountable for improper payments. OHA has identified areas for improvements, but still needs to finish the rule-making process, the report said.