Press Release  Bump: Return on Investment for MassHealth Audits Worth Millions

Boston — State Auditor Suzanne Bump today announced that she will be asking for a budget increase to conduct more audits of MassHealth. Auditor Bump will offer her request in testimony before the Legislature’s Joint Committee on Ways and Means at a hearing on Tuesday.

“It’s a money maker,” said Auditor Bump. “During the previous 12 months, for every dollar my office has spent auditing MassHealth, we have identified $52 in potential savings and recoupment opportunities and we expect this ratio to increase. No one else in state government has the dedicated resources and the technical capability to do the job better than us. So rather than asking ‘can we afford to make this investment in auditing’, ask instead, ‘can we afford not to.’”

In her testimony Auditor Bump will request an additional $300,000 for her office’s Medicaid Audit Unit’s current $864,638 budget. The additional funds will support hiring two additional audit teams for the unit. In the past 12 months the Medicaid Audit Unit identified more than $34 million in unallowable, questionable, duplicative or potentially fraudulent billings and as much as $11.6 million in missed opportunities for federal cost-sharing reimbursements.

“The Governor and legislative leaders have stated their intention to find ways to improve services and wring out unnecessary costs out of MassHealth. For this goal, they will find no better partner than the Office of the State Auditor.”

Since elected, Auditor Bump has stepped up her office’s oversight of MassHealth and audited various aspects of the agency and its service delivery system such as MassHealth’s: eligibility system, dental program, payments for drug screening, and the Limited Program.

In her testimony Auditor Bump will explain to the Ways and Means committees that many MassHealth audits have resulted in substantial, year-over-year savings. Examples include a 2013 audit of Medicaid payments for drug screening tests which found $16.5 million in unallowable and improper billings. Since the audit, MassHealth has updated its claim systems and decreased its average amount paid for monthly drug screenings by more than half. MassHealth has also referred $4.5 million of the identified improper charges to the Attorney General’s office for possible legal action. 

The Office of the State Auditor, with a Fiscal Year 2015 budget of more than $18 million, conducts technical assessments and performance audits of state government’s programs, departments, agencies, authorities, contracts, and vendors. With its reports, the OSA issues recommendations to improve accountability, efficiency, and transparency.

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