Georgia's "ineptitude" in making back-to-back erroneous $45 million payments to the federal government confounds a U.S. district judge. But the state's bungling isn't an excuse for allowing the federal government to keep the $90 million in Medicaid payments that Georgia mistakenly made in 2005 and 2006, U.S. District Judge Gladys Kessler ruled last week.
"It is Georgia's poor, elderly, disabled, and pregnant populations that will suffer the most should these administrative errors stand uncorrected," her opinion states.
Georgia screwed up by overpaying the federal Centers for Medicare and Medicaid Services by $90,050,230. How'd that happen? Blame seems to go to computer systems, accounting and budgeting. Problem one involved Georgia's 2003 launch of a new Medicaid Management Information System to process Medicaid claims. The new system had severe problems that resulted in delays in paying doctors and hospitals, who said they couldn't continue to provide care without payments. So the state gave them advance payments until the problems could be fixed.
Problem two, apparently, was how Georgia classified the advance payments. That led the state to overpay CMS for money it had advanced. Problem three was how Georgia accounted for the payments in its annual budgets, inadvertently crediting $45 million in 2005 and 2006 to CMS. The state didn't realize its mistakes until 2008, after an external auditor flagged other concerns. In 2009, the state tried to get the money back. Too late, said the federal government. Under CMS rules, states get only two years to file claims for mistaken payments.
Facts of the case were on the federal government's side. But the judge took pity, noting that Georgia, "measured against many metrics," is not a wealthy state. "Approximately 18.2% of Georgia's population lives in poverty, giving it the undesirable distinction of having the eighth highest poverty level in the 50 United States," Kessler wrote in the Feb. 10 order. "With regard to personal income per capita, Georgia again has the undesirable distinction of ranking 40th out of all 50 states."
The state's incompetence aside, she wrote that hundreds of thousands of Georgians could be harmed with the loss of $90 million, and the federal government would be unjustly enriched.