Checklist could reduce Medicaid payment errors

abeam@thestate.com February 1, 2012 

South Carolina’s Medicaid agency paid $406 million to people who were not eligible in 2010, and the agency director wants to implement a surgical-style checklist for employees to reduce those mistakes.

In a meeting of a Senate subcommittee Wednesday, Tony Keck blamed many of the mistakes on outdated technology, including using paper files.

“With some of the errors that we are seeing, they are very straightforward. I think following a checklist approach like hospitals are doing now in surgery to make sure don’t cut off the wrong limb or anything else -- if they can do it in surgery, we can certainly do it in eligibility,” said Keck, director of the state Department of Health and Human Services.

The issue came to light earlier this month when a federal audit showed South Carolina’s improper payment rate increased to 17.2 percent, up from 5.3 percent in 2007. The agency says a “large number” of those errors are “technical in nature” and that “applicants would remain eligible if internal procedures were followed.”

Keck said moving to an electronic records system would help, because it would not allow a state employee to process a payment until all the necessary information was collected. The agency’s Greenville office already has this system, but it is not yet available statewide, Keck said.

Reach Beam at (803) 386-7038.

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