Health Alliance Slip-Ups Costly
Byline: Jim McElhatton, THE WASHINGTON TIMES
The failure of D.C. Healthcare Alliance officials to perform routine eligibility checks of people enrolled in a city-funded health plan has cost D.C. taxpayers millions of dollars since 2002, a recent audit found.
The city’s Healthcare Alliance program paid out $13 million in 2002 and 2003 for health services to residents already eligible for Medicaid, according to a finding of the D.C.-based accounting firm KPMG LLP. Auditors forwarded the findings to the D.C. Office of Chief Financial Officer on Jan. 22.
“The Alliance did not perform Medicaid eligibility verifications, and the District’s monitoring of the Alliance’s invoices did not detect this,” the audit said.
The D.C. Department of Health oversees the city-funded health care plan for low-income residents who do not qualify for Medicaid – the federal government’s health care program for low-income people.
The audit findings prompted one D.C. Council member to criticize Chartered Health Plan Inc. – a privately owned health-maintenance organization – which the D.C. government has paid tens of millions of dollars since 2001 to perform eligibility checks and administer Healthcare Alliance claims.
“The contract calls for Chartered Health to screen for Medicaid,” said councilmember David A. Catania, at-large Republican. “They have breached their contract. Their failure to do what they were contracted to do has cost taxpayers millions of dollars.”
“It was a failure to do their job,” Mr. Catania said. “We should find somebody else.”
Chartered Health is owned by Jeffrey E. Thompson, a key political ally of Mayor Anthony A. Williams. Officials at Chartered Health did not return phone calls seeking comment yesterday.
However, Brenda Emanuel, deputy director of the Healthcare Safety Net Administration in the D.C. Department of Health, yesterday defended Chartered Health’s recent performance. She said the company has put reforms in place to make sure the Healthcare Alliance does not pay for health services for people already eligible for Medicaid.