Iowa healthcare system recoups $23 million in recoveries, cost avoidance

Iowa taxpayers have saved more than $23 million as the result of a state Medicaid integrity incentive program that was introduced last year.

According to Medicaid director Jennifer Vermeer, the savings were realized because of a series of strategic implementations such as ensuring paid services are medically necessary and educating hospital staff to help them identify duplicate payments and overages that Medicaid should be reimbursed for.

Additionally, there is a recovery audit system in place to identify the practice of upcoding, which occurs when providers bill for a more expensive service than the one that was provided.

"We've shown that aggressive oversight can result in substantial savings or paybacks of public dollars without jeopardizing essential healthcare for some 400,000 Iowans who rely on Medicaid," Vermeer said in a statement.

A breakdown of the savings revealed that approximately two-thirds are recoupments due to paid claims analysis.

According to a recovery audit contractor update released by the Centers for Medicare & Medicaid Services earlier this month, a total of $233.4 million in overpayments and $55.9 million in underpayments were identified nationwide in the third quarter of fiscal year 2011. 

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