Pa. turns to random audits in bid to track Medicaid dollars

The random reviews are part of a new strategy to make sure contractors aren't misusing Pennsylvania's dollars.

  • Katie Meyer

(Harrisburg) — This week, six Medicaid providers are getting word they’re being audited by the state.

The random reviews are part of a new strategy to make sure contractors aren’t misusing Pennsylvania’s dollars.

Around 80 percent of the state Department of Human Services’ spending goes to outside operators, like the providers that coordinate Medicaid-funded services for seniors and people with intellectual disabilities.

Those two groups of providers are the specific targets of the new slate of audits.

Senate Appropriations Chair Pat Browne noted, spending by contractors generally isn’t subject to review by the state.

But the Lehigh County Republican said there aren’t any laws that prevent closer scrutiny, he thinks it is warranted in order to “give our constituents more confidence that money spent outside by our partners is spent in the way it should be spent.”

Auditor General Eugene DePasquale and his team randomly picked six providers for review. He said it’s an approach designed to keep the thousands of other in-state providers on their toes.

“Anyone could have been on this list,” he said.

Browne and DePasquale said they don’t have any reason to suspect malfeasance.

However, just last week Attorney General Josh Shapiro announced that a grand jury had found what he called “systemic” misuse of Medicaid funds by providers.

He said investigators had recovered more than $34 million in bad payments, and that they likely missed many more.

DePasquale said his impending audits aren’t related to the grand jury investigation.

The providers selected for review are as follows:

–        CMU – Case Management Unit, Harrisburg

–        Masonic Village, Elizabethtown

–        The Gardens at Wyoming Valley, Wilkes-Barre

–        Dr. Gertrude A. Barber Center Inc., Erie

–        Path Inc., Philadelphia

–        Shadowfax Corp., York

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