Tribes Overpaying for Medical Services

During just one three-month period in 2008, the Indian Health Service and tribes paid $14 million over the Medicare rate for medical services, according to a Health and Human Services Inspector General’s report released last week. The money for the services comes from the Contract Health Services program -- a program so cash-strapped every year that it cannot cover medical care for tribal members for a full fiscal year, giving rise to the wry admonishment frequently heard in Indian Country … “Don’t get sick after June.”

Between January and March last year, IHS and tribes paid above the Medicare rate for 22 percent of hospital claims, resulting in $1 million in overpayments. But most overpayments were for hospital outpatient claims. If IHS and tribal payments for non hospital claims were capped at the Medicare rate, they could have saved as much as $13 million between January and March 2008.

While 22 percent of hospital claims were paid above the Medicare rate, the resulting overpayments only accounted for 3 percent of the total $33 million that IHS and tribes spent on hospital claims between January and March 2008, according to the report. IHS and tribes paid above the Medicare rate for 71 percent of non hospital claims. Most of these claims paid above the Medicare rate were for physician services.

GOP Blocks Vote on Sebelius for HHS

Saying they needed more time to consider her record, Senate Republicans Thursday refused to allow confirmation vote on Gov. Kathleen Sebelius (D-Kansas), President Obama’s nominee to head the Department of Health and Human Services. Read more in the Washington Post.

Nepotism Costs Head Start Grantee over $66,000

The HHS appeals board recently upheld the disallowance of $66,888 in salary paid to the sister of a Head Start center’s CEO. The L.I. Child and Family Center employed the sister of the CEO in violation of the center’s own personnel policy and provisions of the Head Start law and regulations prohibiting any taint of “partisan political bias or personal or family favoritism” in the conduct of Head Start programs. Even though the case did not deal specifically with a tribal program, tribal Head Start programs are subject to the same laws and regulations.