State of Wyoming Arranges with Campbell County Health Over Medicaid Billing Audit

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The Wyoming State Capitol lit up at night during the 2020 session. (Mike Vanata / WyoFile)

CASPER, Wyo – Wyoming Attorney General Bridget Hill announced Friday that the Campbell County Hospital District has reached a civil settlement in which the district agreed to pay $ 1,500,000 to resolve allegations that the program Children’s summer violated the Wyoming Medicaid False Claims Act.

The Children’s Summer Program was offered by the Hospital’s Behavioral Health Services Children’s Clinic as a treatment option for children and families in Campbell County.

According to the AG’s statement, an audit conducted by the Attorney General’s Medicaid Fraud Control Unit identified concerns with program documentation and staff oversight.

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“The unit also identified concerns that the children’s summer program has billed Wyoming Medicaid for activities that are not covered by Medicaid services,” the statement said.

By submitting these invoices, the state is claiming that the hospital district received payments to which it was not entitled.

To address the states’ issues, the Campbell County Hospital District agreed to pay $ 1,500,000, which covers the program’s Medicaid claims from 2015 to 2019.

The hospital district also agreed to enter into a three-year corporate integrity agreement with the Attorney General’s Medicaid fraud control unit, the statement said. The agreement is designed to ensure that future claims meet the requirements of the state’s health care program.

The state acknowledges that the Campbell County Hospital District cooperated with this audit.

“We appreciate the state for its good collaboration with our organization and for bringing its concerns about our summer program to our attention. It was a great learning experience for our hospital, ”said Adrian Gerrits, Chairman of the Campbell County Board of Health.

“It is important to the success of Wyoming Medicaid that all providers bill the program accurately and honestly, as Wyoming Medicaid pays for medical care for some of Wyoming’s most vulnerable citizens. said Attorney General Bridget Hill.

“I would like to commend the Medicaid Fraud Control Unit for their work in this matter and for their continued work in protecting the Wyoming taxpayer funds used to fund Wyoming Medicaid,” Hill added. I would also like to thank the Campbell County Hospital District for cooperating with our audit and working with us to resolve this issue. ”

From the exit:

“The Wyoming Attorney General’s Medicaid Fraud Control Unit investigates and prosecutes Medicaid fraud, false Medicaid claims, and related criminal and civil violations committed by Wyoming Medicaid healthcare providers.

“The unit also investigates and prosecutes cases of abuse, neglect or financial exploitation by Medicaid providers and in health facilities funded by Medicaid. The unit receives 75% of its funding from the US Department of Health and Human Services in a grant totaling $ 344,536 for federal fiscal year 2021.

“The remaining 25%, totaling $ 114,841, is funded by the state of Wyoming. Wyoming residents who suspect health care fraud, misrepresentation, or related activity are encouraged to report it by calling the Medicaid Fraud Control Unit Hotline at 1-800-378 -0345, or by visiting its website.

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