Audit finds waste in hospital stays, says state could reduce Medicaid costs
Published: 2010-07-15 19:37:11By: nola.com | April 12, 2010
The state Department of Health and Hospitals is not doing enough to prevent unnecessary hospital admissions, an oversight that may be driving up the cost of the Medicaid program, according to an audit released Monday.
The health department is also using outdated criteria to determine how long patients should stay in the hospital, and Medicaid may be paying unnecessarily for hospital days incurred as a result of infections acquired in the hospital, the report by the legislative auditor says.
In a written response to the audit, Health and Hospitals Undersecretary Jerry Phillips said the agency agrees with the recommendations, and that changes have already been made to provide better oversight.
While it's unclear how much money the state is spending on hospital stays that aren't justified by clinical criteria, the audit found that an estimated 80 percent of the 218,784 Medicaid inpatient admissions in 2009 were not reviewed to make sure they were medically necessary.
Louisiana, like other states, uses a private company to handle Medicaid claims filed by health care providers such as doctors, hospitals and pharmacies. At $34 million a year, the state's contract with Unisys Corp. is the largest in state government.
Full story