The word from a reliable source is that FNS Dallas is now investigating the overpayments in TIERS that have been occuring for more than 1 year.
Again, from reliable sources, no fix has been implemented so the overpayments continue & OIG is not attempting to recover these overpayments because of the difficulty is determining what occurred on a case action in TIERS. FNS will consider these agency errors due to system problems.
Therefore, they are state liabilities that must be paid out of state, NOT federal, funds. A year ago, the estimate of this liability was $1.4 million.
Also, word is that FNS Regional Administrator William Ludwig sent HHSC Commissioner Hawkins another "Dear Al" letter in the past few weeks - denying retroactive funding for the call center initiative to the tune of $24 million!
Therefore, Al will have to break the news to the lege that the $24 mil must come out of the state coffers! Ms. Strayhorn will not like that. Go one-tough-grandma!
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Are these overpayment from client error/worker error or is it that flaw in TIERS that when a Medicaid is touched, for example- TIERS will sometimes reissue supplements the client has received in the past (we had one that had over $2,000 appear on her Lone Star Card- upon investigation, it appeared that when the XIX cases were updated, TIERS reissued supplements the client had received in 2004 and 2005.).....
My understanding is that they are overpayments caused by TIERS, but I also know from a "source" that OIG is NOT investigating any cases that are in TIERS at all because they can't prove if the fault lies with the client or the system.
If you could determine how the extra $2000 appeared, why isn't OAG pursuing any cases?
Can you imagine what would happen if the clients got wind of that? I hope none have found this site but I do have educated, knowledgeable people for clients so you never know...
Did they ever recoup that $2000?
You also got me to thinking....how long did it take them to find the error and identify the cause of it?
The only reason it was found was due to the CLIENT calling as she was unsure why her account was so high.
I have no idea if they are pursuing the overpayment- the client was advised to not spend the overpayment.
This is, apparently, happening A LOT.
You are doing a great job on the blog-
Thanks!
Check out Ramblings of an HHSC Employee Amidst Chaos also!
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