After a several month delay, a preliminary report on Medicaid fraud and waste in Delaware is out, showing the state may have lost at least $4.1 million over the past three years.
More than half of the fraud or waste comes from doctors potentially charging an inpatient rate for outpatient services.
The report from contractor Health Integrity says that data would need to be reviewed by an independent medical professional to be fully verified.
Another large chunk comes from some patients potentially receiving stainless steel crowns during visits to their dentist that they didn’t medically need, according to the report.
Health Integrity only looked at charges outside managed care plans, like HMOs. Those plans to be reviewed in the future.
The budget writing Joint Finance Committee (JFC) last year set aside $500,000 to pay for a pilot program to sniff out fraud and waste within the Medicaid program, with co-chair Sen. Harris McDowell (D-Wilmington North) expecting to net $12 million each year from the program.
Department of Health and Social Services officials were supposed to have contracted with an outside company by last October, but failed to do so until March, much to the chagrin of state lawmakers.
Health Integrity will be paid $250,000 for their preliminary work, with the other $250,000 to be paid after the state realizes any savings.
A more in-depth review is ongoing, with a final report to be sent to JFC.